Chronic Pain and Behavior

Objective.To develop and evaluate process indicators relevant to biopsychosocial history taking in patients with chronic back and neck pain.Methods.The SCEBS method, covering the Somatic, Psychological (Cognition, Emotion, and Behavior), and Social dimensions of chronic pain, was used to evaluate biopsychosocial history taking by manual physical therapists (MPTs). In Phase I, process indicators were developed while in Phase II indicators were tested in practice.Results.Literature-based recommendations were transformed into 51 process indicators. Twenty MTPs contributed 108 patient audio recordings. History taking was excellent (98.3%) for the Somatic dimension, very inadequate for Cognition (43.1%) and Behavior (38.3%), weak (27.8%) for Emotion, and low (18.2%) for the Social dimension. MTPs estimated their coverage of the Somatic dimension as excellent (100%), as adequate for Cognition, Emotion, and Behavior (60.1%), and as very inadequate for the Social dimension (39.8%).Conclusion.MTPs perform screening for musculoskeletal pain mainly through the use of somatic dimension of (chronic) pain. Psychological and social dimensions of chronic pain were inadequately covered by MPTs. Furthermore, a substantial discrepancy between actual and self-estimated use of biopsychosocial history taking was noted. We strongly recommend full implementation of the SCEBS method in educational programs in manual physical therapy.

Download Full-text

The Longitudinal Impact of Parent Distress and Behavior on Functional Outcomes Among Youth With Chronic Pain

Journal of Pain ◽

10.1016/j.jpain.2016.02.014 ◽

2016 ◽

Vol 17 (6) ◽

pp. 729-738 ◽

Cited By ~ 55

Author(s):

Erika T. Chow ◽

John D. Otis ◽

Laura E. Simons

Keyword(s):

Chronic Pain ◽

Functional Outcomes ◽

Longitudinal Impact ◽

Parent Distress ◽

And Behavior

Download Full-text

COMORBIDITY OF NON-PSYCHOTIC MENTAL DISORDERS AND NEUROLOGIC SYMPTOMS AMONG YOUNG PEOPLE

Wiadomości Lekarskie ◽

10.36740/wlek202008103 ◽

2020 ◽

Vol 73 (8) ◽

pp. 1605-1609

Author(s):

Valeriy М. Pashkovskyy ◽

Оlha S. Yurtsenyuk

Keyword(s):

Chronic Pain ◽

Young People ◽

Mental Disorders ◽

Somatoform Disorders ◽

Pain Syndrome ◽

Behavioral Syndromes ◽

Clear Correlation ◽

Physical Factors ◽

Chronic Pain Syndrome ◽

And Behavior

The aim: to determine occurrence and structure of non-psychotic mental disorders associated with chronic pain among young people. Materials and methods: The results of examination of 1235 students were analyzed. The following methods were applied: clinical, clinical-psychopathological, clinicalepidemiological, clinical-anamnestic, experimental-psychological and statistical. Results: Students with neurotic disorders associated with stress and somatoform disorders were found to prevail in the main group (F40-48.1) 187 (58,99%), affective mood disorders were on the second position (F30-34.1) - 79 (24,92%) individuals, followed by disorders of a mature personality and behavior of adults (F60-60.7) diagnosed in 31 (9,78%) students, and at last, behavioral syndromes associated with physiological disorders and physical factors (F50-51.4) - 20 (6,30%) respectively. Chronic pain syndrome was diagnosed in 113 (35,65%) students with NMD including 43 (38,05%) men and 70 (61,95%) women. The majority of young people (86 individuals – 76,11%) observed severe pain, and 27 (23,89%) of them – moderate pain. A clear correlation was found between a depressive episode and CPS (γ<0,02). Conclusions: The findings obtained should be considered in development of screening systems concerning diagnostics, prevention of nonpsychotic mental disorders associated with chronic pain syndrome.

Download Full-text

Chapter 14 or 18 for Pain Complaints? Guidance From Chapter 18 and Other Pain Resources

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2005.mayjun01 ◽

2005 ◽

Vol 10 (3) ◽

pp. 1-3, 10-12

Author(s):

Robert J. Barth

Keyword(s):

Chronic Pain ◽

Mental Illness ◽

Decision Rule ◽

Psychological Factors ◽

Potential Solution ◽

Statistical Manual ◽

Diagnostic And Statistical Manual ◽

And Behavior ◽

Physical Findings ◽

Active Disease

Abstract This article is part three of a four-part series that examines the rating of pain complaints and mental illness using the AMA Guides to the Evaluation of Permanent Impairment, (AMA Guides). Chapter 18 provides physicians with a method for evaluating impairment associated with “chronic pain states” for which there may be “no demonstrable active disease or unhealed injury,” and Chapter 14 should be considered when symptoms are out of proportion to physical findings. This article focuses on the directions from Chapter 18 and other pain resources. The authors note that Chapter 18 specifically addresses the issue of distinguishing between uses of Chapters 18 and 14, but the directions are contradictory with respect to the key question, Do “psychological factors” play a “major role” in the presentation of pain? Resources such as Bonica's Management of Pain point out that “[t]issue damage and nociception are neither necessary nor sufficient for pain,” suggesting that psychological factors are nearly always present and obviating the use of Chapter 18. A potential solution would be to ask, “Is the presentation of pain consistent with any mental illness as defined in the American Psychiatric Association's Diagnostic and Statistical Manual?” The decision rule then would be if the presentation of pain is consistent with any mental illness, then the mental and behavior chapter should be used.

Download Full-text

Suicidal ideation and behavior associated with antidepressant medications: Implications for the treatment of chronic pain

Pain ◽

10.1016/j.pain.2014.08.022 ◽

2014 ◽

Vol 155 (12) ◽

pp. 2471-2475 ◽

Cited By ~ 6

Author(s):

Anthony Pereira ◽

Yeates Conwell ◽

Michael J. Gitlin ◽

Robert H. Dworkin

Keyword(s):

Chronic Pain ◽

Suicidal Ideation ◽

Antidepressant Medications ◽

And Behavior

Download Full-text

Clinical Holistic Medicine: Social Problems Disguised as Illness

The Scientific World JOURNAL ◽

10.1100/tsw.2004.27 ◽

2004 ◽

Vol 4 ◽

pp. 286-294 ◽

Cited By ~ 2

Author(s):

Søren Ventegodt ◽

Mohammed Morad ◽

Isack Kandel ◽

Joav Merrick

Keyword(s):

Chronic Pain ◽

Social Problems ◽

Holistic Approach ◽

Social Situation ◽

Holistic Medicine ◽

The Family ◽

The World ◽

And Behavior

Many of the diseases seen in the clinic are actually symptoms of social problems. It is often easier for the physician to treat the symptoms than to be a coach and help the patient to assume responsibility in order to improve quality of life, social situation, and relations. If the physician ignores the signs of the disease as a symptom of social problems, and treats the patient with pharmaceuticals, he can give the patient the best justification in the world not to do anything about the situation. It is very important that the physician is not tricked by the games the socially troubled patient, more or less unconsciously, is playing. A firm and wise attitude that confronts the patient with his or her lack of responsibility for solving social problems seems to be a constructive way out. The physician can give holding and support, but the responsibility must remain with the patient. Often it is better for the patient that the physician abstains from giving drugs that can remedy the symptoms and takes the role of a coach instead. Suffering is not necessarily bad, suffering is actually highly motivating and often the most efficient source of learning. Coaching can help the patient canalize his motivation into highly constructive considerations and behavior. A holistic approach thus gives the patient learning and helps him rehabilitate his social reality. Concerning children with recurrent or chronic pain, we have observed an overuse of painkillers, where we believe part is of a psychosomatic nature due to poor thriving in the family. Here the physician has an important job helping the parents to develop as persons, teaching them the basic holding of awareness, respect, care, acknowledgment and acceptance of their child. Most of the chronic pain and discomfort with children can be improved if the physician understands how to use the holistic medical toolbox.

Download Full-text

“Why Isn’t It Going Away?”: A Qualitative Exploration of Worry and Pain Experiences in Adolescents with Chronic Pain

Pain Medicine ◽

10.1093/pm/pnaa245 ◽

2020 ◽

Author(s):

Marese Heffernan ◽

Charlotte Wilson ◽

Kim Keating ◽

Kevin McCarthy

Keyword(s):

Chronic Pain ◽

Pain Catastrophizing ◽

Pain Clinic ◽

Pain Beliefs ◽

Critical Realist ◽

Psychometric Measures ◽

Outcomes For Children ◽

Pain Experiences ◽

And Behavior ◽

Qualitative Exploration

Abstract Introduction The role of cognition is central to the fear avoidance (FA) model of chronic pain (CP), which emphasizes the importance of catastrophic pain interpretations and has been shown to be applicable to pediatric CP populations. However, while we know that pain catastrophizing plays a distinct role in influencing outcomes for children with CP, we know little about the specifics of how young people with CP experience catastrophizing and worry, as well as their general pain beliefs. Objective To qualitatively explore beliefs about and experiences of worry and pain among a purposeful sample of adolescents with CP. Methods Individual semistructured interviews with 12 adolescents (aged 12–17) with varying forms of CP attending an outpatient pain clinic in a general children’s hospital. Relevant psychometric measures were administered orally to further inform the data. Data were analyzed using critical realist thematic analysis. Results Three themes and one subtheme were identified. Themes were 1) the worry ripple: mind, body, and behavior (subtheme: worry content: personal competence and health); 2) the pain mystery: living in a “scribble of black”; and 3) the resist or avoid conundrum. Conclusions The findings highlight the need for psychological interventions targeting acceptance of uncertainty and also informing education on mind/body connections in adolescents with CP.

Download Full-text