Elsevier

The Journal of Pain

Volume 5, Issue 4, May 2004, Pages 195-211
The Journal of Pain

Invited commentary
Psychological aspects of persistent pain: current state of the science

https://doi.org/10.1016/j.jpain.2004.02.576Get rights and content
Under an Elsevier user license
open archive

Abstract

This article provides an overview of current research on psychological aspects of persistent pain. It is divided into 3 sections. In section 1, recent studies are reviewed that provide evidence that psychological factors are related to adjustment to persistent pain. This section addresses research on factors associated with increased pain and poorer adjustment to pain (ie, pain catastrophizing, pain-related anxiety and fear of pain, and helplessness) and factors associated with decreased pain and improved adjustment to pain (ie, self-efficacy, pain coping strategies, readiness to change, and acceptance). In section 2, we review recent research on behavioral and psychosocial interventions for patients with persistent pain. Topics addressed include early intervention, tailoring treatment, telephone/Internet-based treatment, caregiver-assisted treatment, and exposure-based protocols. In section 3, we conclude with a general discussion that highlights steps needed to advance this area of research including developing more comprehensive and integrative conceptual models, increasing attention to the social context of pain, examining the link of psychological factors to pain-related brain activation patterns, and investigating the mechanisms underlying the efficacy of psychological treatments for pain.

Perspective

This is one of several invited commentaries to appear in The Journal of Pain in recognition of The Decade of Pain Research. This article provides an overview of current research on psychological aspects of persistent pain, and highlights steps needed to advance this area of research.

Keywords

Persistent pain
psychological factors
adjustment
behavioral intervention
psychological intervention

Cited by (0)

Editor’s note: This commentary by Francis J. Keefe et al, entitled “Psychological Aspects of Persistent Pain: Current State of the Science,” provides an in-depth look at psychological facets of unrelenting pain. This is one of several invited commentaries that will appear in The Journal of Pain, each addressing research needs in different disciplines of American Pain Society membership. These commentaries were invited from leading figures in the American Pain Society in observance of The Decade of Pain Control and Research, declared by Congress beginning January 1, 2001. Authors were asked to critically evaluate the status of pain research and to identify areas that need more focus, as well as areas that offer significant promise. Keefe et al note the need for more research that focuses on persistent pain, such as investigating mechanisms that regulate the efficacy of psychological treatments for pain, examining the link of psychological factors to pain-related brain activation patterns, and developing better conceptual models to help broaden this field. It is hoped that this and other commentaries to follow will promote research with a focus on improving care, enhancing professional awareness, and influencing federal policy.