Cited by 118Musculoskeletal pain and rehabilitationPsychosomatic Disorders and Their TreatmentsMedicine, History, and Philosophy

The role of psychological factors in chronic pain. II. A critical appraisal

Gamsa, Ann·1994·Pain

Abstract

This paper, the second of two, concerning the study of psychological factors in chronic pain, presents a critical appraisal of the literature. Questionable assumptions, flawed methodology, and conceptual problems in earlier work are discussed, as are gradual improvements in methodological rigour and conceptual clarity. Methodological weaknesses in studies, including lack of control groups, selection biases, overinterpretation of correlational data, and use of inappropriate testing instruments are examined. Questions are raised about persisting tendencies to split mind from body by attributing pain to either organic or psychological causes. Despite advances in research and thinking in recent years, several issues remain unresolved in both the research enterprise and the clinical setting. These are discussed in relation to the respective needs of the researcher, the clinician, and the patient. Limitations on research conducted in clinical settings are considered and targets for improved methodology in studies are identified.

Integrity signals

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Crossref · 10.1016/0304-3959(94)90104-x

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164 of 164 references verified0 citation errors · 0 not checkable

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  • Rewarding events by family members (attention, sympathy, permission to avoid obligations, financial compensation) may increase the frequency and intensity of pain expression and reinforce illness behavior.

    “it has been proposed that the presence of rewarding events by family members, such as attention, sympathy, permission to avoid unpleasant obligations, and, sometimes, financial compensation, may increase the frequency and intensity of pain expression and reinforce the illness behavior.103,104”

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Authors
Gamsa, A.
Affiliations
Montreal General Hospital (CA)
Corresponding author
Gamsa, Ann
Venue
Pain
Published
1994-04
Volume
57
Issue
1
Pages
17-29
ISSN
0304-3959 (ISSN-L)
OpenAlex
W2039934014
Cited by
118
References
164
Citations by year
2023: 1 · 2022: 1 · 2021: 1 · 2020: 2 · 2018: 1 · 2017: 1 · 2012: 1
FWCI
1.34
Type
journal article
Language
en
Open access
closed
Locations
  • Pain (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Health Sciences › Medicine › Psychiatry and Mental health › Medicine, History, and Philosophy
Keywords
chronic pain, psychological factors, mind-body problem, methodological weaknesses, selection bias, control groups, test equipment, clinical pain management
MeSH terms
Chronic Disease, Humans, Pain

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