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The role of psychological factors in chronic pain. II. A critical appraisal
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.
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“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”
From Pain and Evil: From Local Nociception to Misery Following Social Harm (2020) · cites this paper as [103]
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Metadata
- 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 › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Arts and Humanities › History and Philosophy of Science › 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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