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Participants completed a structured questionnaire to determine the prevalence and nature of the triggers of phantom phenomena. The four categories of triggers identified include: (a) a quarter of participants experiencing psychological, emotional or autonomic triggers; (b) half experiencing behavioral triggers, \u201cforgetting\u201d the limb's absence and attempting to use the phantom; (c) one\u2010fifth experiencing weather\u2010induced triggers; and (d) one\u2010third experiencing sensations referred from parts of the body. Upper limb amputees; and were more likely to experience weather\u2010induced phantom phenomena than lower limb amputees; and upper and lower limb amputees were equally likely to experience referred sensations from the genitals, contradicting the homuncular remapping hypothesis. Traumatic amputees were more likely to report emotional triggers. Further, while those with emotional triggers exhibited poorer acceptance of the limitations of amputation, they were more likely to employ adaptive coping mechanisms. Finally, habitual \u201cforgetting\u201d behaviors were most common soon after amputation, whereas other more adaptive schemata (e.g., self\u2010defense) were equally likely to be performed at any time following amputation. Various likely inter\u2010related mechanisms are discussed in relation to phantom triggers. Ultimately, optimizing stump and neuroma management, as well as restoring function of central networks for pain, limb movement, and amputation\u2010related memories, should help manage spontaneously triggered phantom phenomena.<\/jats:p>","DOI":"10.1016\/j.ejpain.2011.01.005","type":"journal-article","created":{"date-parts":[[2011,2,12]],"date-time":"2011-02-12T11:32:27Z","timestamp":1297510347000},"source":"Crossref","is-referenced-by-count":7,"title":["The menacing phantom: What pulls the trigger?"],"prefix":"10.1002","volume":"15","author":[{"given":"Melita J.","family":"Giummarral","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nellie","family":"Georgiou\u2010Karistianisl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael E.R.","family":"Nichollsl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen J.","family":"Gibsonl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Choul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John L.","family":"Bradshawl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,1,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0031-9384(99)00235-8"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(90)90009-S"},{"issue":"2","key":"e_1_2_7_4_1","first-page":"128","article-title":"The relationship involving humidity level, temperature and phantom limb pain: preliminary analysis","volume":"14","author":"Arena J.G.","year":"1989","journal-title":"Biofeedback Self Regul"},{"key":"e_1_2_7_5_1","first-page":"391","volume-title":"Advances in pain research and therapy. 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