The Role of Beliefs in Chronic Pain and Possible Therapies (original) (raw)
Related papers
Pain beliefs: assessment and utility
Pain, 1994
When pain becomes persistent, patients may abandon previously held cultural or personal beliefs about pain to form new pain beliefs that are more consistent with their persistent pain experience. The Pain Beliefs and Perceptions Inventory (PBPI) is an instrument to assess these new beliefs. This paper presents 4 studies examining the utility of the PBPI. Two studies are factor analytic and support recent literature identifying 4 belief factors associated with this instrument. The third and fourth studies used a new scoring method for the PBPI creating 4 scales: Mystery, Self-blame, Pain Permanence, and Pain Constancy. These scales were then correlated with important pain indices such as measures of pain quality, psychological states (i.e., depression and anxiety), personality traits, physical functioning, and coping strategies. Each belief appears to have a unique association with the pain indices thus supporting the restoring of this instrument with 4 scales. Belief in pain constancy is associated with greater pain self-report, permanence is associated with anxiety, mystery is associated with greatest overall distress, and self-blame is associated with depressive symptoms. An appendix is included that provides clinical norms for the use of the PBPI and a revised scoring key.
Health-related Quality of Life and Pain Beliefs Among People Suffering From Chronic Pain yyy
2004
hronic pain, when not effectively treated and relieved, may have a armful effect on all aspects of health-related quality of life (HRQL). urthermore, pain beliefs are considered an important mediating psyhological factor in chronic pain. The present study focused on HRQL s measured by the Medical Outcomes Survey-Short Form (SF-36) and ddressed possible relationships between pain beliefs as measured by he Pain Beliefs and Perceptions Inventory (PBAPI). The possible imact of background variables such as age, gender, social support, pain ntensity, pain duration, and analgesics on HRQL were controlled for n the analyses. The study sample consisted of 81 people who were ecruited from a multidisciplinary pain management program. Data ere collected as the first part of a routine pretreatment evaluation. he chronic-pain patients reported lower scores on all dimensions of RQL compared to normal controls and other patient groups. No sigificant association was found between pain beliefs and th...
Health-related quality of life and pain beliefs among people suffering from chronic pain
Pain Management Nursing, 2004
Chronic pain, when not effectively treated and relieved, may have a harmful effect on all aspects of health-related quality of life (HRQL). Furthermore, pain beliefs are considered an important mediating psychological factor in chronic pain. The present study focused on HRQL as measured by the Medical Outcomes Survey-Short Form (SF-36) and addressed possible relationships between pain beliefs as measured by the Pain Beliefs and Perceptions Inventory (PBAPI). The possible impact of background variables such as age, gender, social support, pain intensity, pain duration, and analgesics on HRQL were controlled for in the analyses. The study sample consisted of 81 people who were recruited from a multidisciplinary pain management program. Data were collected as the first part of a routine pretreatment evaluation. The chronic-pain patients reported lower scores on all dimensions of HRQL compared to normal controls and other patient groups. No significant association was found between pain beliefs and the physical health dimension of HRQL whereas gender, pain duration, and pain intensity were significant predictors of that dimension. In addition, one of the dimensions of pain beliefs (i.e., mystery) was found to be predictive of the mental health dimension of HRQL. Social support made an additional contribution to the explained variance in mental health. The implications of these results for assessing HRQL and pain beliefs in chronic pain are discussed.
Beliefs about the body and pain: the critical role in musculoskeletal pain management
Brazilian Journal of Physical Therapy, 2021
Background: Beliefs about the body and pain play a powerful role in behavioural and emotional responses to musculoskeletal pain. What a person believes and how they respond to their musculoskeletal pain can influence how disabled they will be by pain. Importantly, beliefs are modifiable and are therefore considered an important target for the treatment of painrelated disability. Clinical guidelines recommend addressing unhelpful beliefs as the first line of treatment in all patients presenting with musculoskeletal pain. However, many clinicians hold unhelpful beliefs themselves; while others feel ill-equipped to explore and target the beliefs driving unhelpful responses to pain. As a result, clinicians may reinforce unhelpful beliefs, behaviours and resultant disability among the patients they treat. Methods: To assist clinicians, in Part 1 of this paper we discuss what beliefs are; how they are formed; the impact they can have on a person's behaviour, emotional responses and outcomes of musculoskeletal pain. In Part 2, we discuss how we can address beliefs in clinical practice. A clinical case is used to illustrate the critical role that beliefs can have on a person's journey from pain and disability to recovery. Conclusions: We encourage clinicians to exercise self-reflection to explore their own beliefs and better understand their biases, which may influence their management of patients with musculoskeletal pain. We suggest actions that may benefit their practice, and we propose key principles to guide a process of behavioural change.
Chronic Pain and Fear-Avoidance Beliefs: A Narrative Review
https://www.ijhsr.org/IJHSR\_Vol.11\_Issue.6\_June2021/IJHSR-Abstract.034.html, 2021
Chronic pain has an impact not only on the physical function but also affects the quality of life of an individual. Psychosocial factors play an important role in mediating chronic pain. Fear-avoidance belief is considered as the important psychosocial factor in predicting patient's avoidance for work and physical activity as well as disability and has strong association with chronic pain. The aim of the study is to review the studies on the relationship between chronic pain and fear-avoidance beliefs. Articles from the PubMed, Research gate, Google Scholar and APTA databases were searched for this narrative review with related keywords like chronic pain, chronic musculoskeletal pain, fear avoidance beliefs, psychosocial factors and quality of life. Total fifteen articles were found. Out of which, five were excluded and ten were studied further. The sum of evidences proves that the fearavoidance belief is an important predictor of pain. Through this we conclude that the anticipation of chronic pain can further provoke fear-avoidance behaviour and can give rise to a vicious cycle, in which fear can contribute to avoidance of physical activity and work leading to disability.
Journal of Hand Therapy, 1997
iven that pain is a noxious experience, it might be something we wish we could do without. However, to be capable of a pain experience holds tremendous survival value. Pain provides information about body function, helps to prevent current injury by signaling tissue stress, and helps us to learn how to avoid future harm. It is also the most commonly cited reason for seeking medical treatment' and serves as a stimulus to increase compliance with medical regimens. Not only is pain the primary motivating factor in seeking medical care, it is also probably the most effective means by which people are forced to abandon or delay normal daily activities. Pain can disrupt one's financial stability, contribute to increased aggression, and promote the deterioration of relationships with family and friends. Therefore, from a practical standpoint, it is of great benefit to have a comprehensive understanding of this phenomenon. Among the challenges facing pain researchers and clinicians is that a variety of factors affect pain perception, and there are many different types of pain. Pain is described as acute when it lasts for less than 6 months; it is described as chronic when it lasts longer than that," Chronic pain can severely impair the ability of the patient to function at even the most basic levels-socially, vocationally, and recreationally.
Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2008
Chronic pain is a prevalent and costly problem that eludes adequate treatment. Persistent pain affects all domains of people's lives and in the absence of cure, success will greatly depend on adaptation to symptoms and self-management. We reviewed the psychological models that have been used to conceptualize chronic pain-psychodynamic, behavioural (respondent and operant), and cognitive-behavioural. Treatments based on these models, including insight, external reinforcement, motivational interviewing, relaxation, meditation, biofeedback, guided imagery, and hypnosis are described. The cognitive-behavioural perspective has the greatest amount of research supports the effectiveness of this approach with chronic pain patients. Importantly, we differentiate the cognitive-behavioural perspective from cognitive and behavioural techniques and suggest that the perspective on the role of patients' beliefs, attitudes, and expectations in the maintenance and exacerbation of symptoms ar...
The role of psychological interventions in the management of patients with chronic pain
Psychology Research and Behavior Management, 2011
Chronic pain can be best understood from a biopsychosocial perspective through which pain is viewed as a complex, multifaceted experience emerging from the dynamic interplay of a patient's physiological state, thoughts, emotions, behaviors, and sociocultural influences. A biopsychosocial perspective focuses on viewing chronic pain as an illness rather than disease, thus recognizing that it is a subjective experience and that treatment approaches are aimed at the management, rather than the cure, of chronic pain. Current psychological approaches to the management of chronic pain include interventions that aim to achieve increased self-management, behavioral change, and cognitive change rather than directly eliminate the locus of pain. Benefits of including psychological treatments in multidisciplinary approaches to the management of chronic pain include, but are not limited to, increased self-management of pain, improved pain-coping resources, reduced pain-related disability, and reduced emotional distress-improvements that are effected via a variety of effective self-regulatory, behavioral, and cognitive techniques. Through implementation of these changes, psychologists can effectively help patients feel more in command of their pain control and enable them to live as normal a life as possible despite pain. Moreover, the skills learned through psychological interventions empower and enable patients to become active participants in the management of their illness and instill valuable skills that patients can employ throughout their lives.
Current psychological approaches to the management of chronic pain
Current Opinion in Anaesthesiology, 2007
Purpose of review To provide a review of the rationale and evidence supporting three frequently used psychosocial interventions for chronic pain: cognitive-behavioral therapy, operant behavioral therapy and self-hypnosis training. We also review recent work in these areas, with an emphasis on the 2006 publishing year. Recent findings Recent clinical trials and laboratory work continue to support the use of cognitive-behavioral therapy and operant behavioral therapy as adjunctive treatments for chronic pain. Notable areas of new research include a novel program of systematic exposure to pain-related fear (such as fear of reinjury) and the adaptation of cognitivebehavioral therapy for special pain groups (e.g. juveniles and those with pain secondary to physical disability). Regarding self-hypnosis training, recent work suggests that hypnosis can provide temporary pain relief to the majority of individuals with chronic pain and that a substantial minority of these patients experience a clinically significant reduction in baseline pain over time. Summary Cognitive-behavioral therapy and operant behavioral therapy treatments focus on factors that exacerbate or maintain suffering in chronic pain, and should be considered as part of a multidisciplinary treatment paradigm. Self-hypnosis training may also be of benefit, although it appears to be no more (or less) effective than other relaxation strategies that include hypnotic elements.