The Role of Psychosocial Processes in the Development and Maintenance of Chronic Pain

JOURNAL OF PAIN

卷:17

Article

Edwards, Robert R.^1,2  Dworkin, Robert H.^3,4  Sullivan, Mark D.⁵  Turk, Dennis C.⁶  Wasan, Ajay D.⁷ 

[1] Brigham & Womens Hosp, Dept Anesthesiol, Boston, MA 02115 USA

[2] Harvard Univ, Boston, MA 02115 USA

[3] Univ Rochester, Sch Med & Dent, Dept Anesthesiol, Rochester, NY USA

[4] Univ Rochester, Sch Med & Dent, Dept Neurol, Rochester, NY 14642 USA

[5] Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA

[6] Univ Washington, Dept Anesthesiol & Pain Med, Seattle, WA 98195 USA

[7] Univ Pittsburgh, Dept Anesthesiol, Pittsburgh, PA USA

关键词: Biopsychosocial;    phenotype;    chronic pain;    affect;    fear-avoidance;   

DOI  :  10.1016/j.jpain.2016.01.001

来源: Elsevier

【 摘 要 】

The recently proposed Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION)-American Pain Society (APS) Pain Taxonomy (AAPT) provides an evidence-based, multidimensional, chronic pain classification system. Psychosocial factors play a crucial role within several dimensions of the taxonomy. In this article, we discuss the evaluation of psychosocial factors that influence the diagnosis and trajectory of chronic pain disorders. We review studies in individuals with a variety of persistent pain conditions, and describe evidence that psychosocial variables play key roles in conferring risk for the development of pain, in shaping long-term pain-related adjustment, and in modulating pain treatment outcomes. We consider general psychosocial variables such as negative affect, childhood trauma, and social support, as well as pain-specific psychosocial variables that include pain-related catastrophizing, self efficacy for managing pain, and pain-related coping. Collectively, the complexity and profound variability in chronic pain highlights the need to better understand the multidimensional array of interacting forces that determine the trajectory of chronic pain conditions. Perspective: The AAPT is an evidence-based chronic pain classification system in which psychosocial concepts and processes are essential in understanding the development of chronic pain and its effects. In this article we review psychosocial processes that influence the onset, exacerbation, and maintenance of chronic pain disorders. (C) 2016 by the American Pain Society

【 授权许可】

Free