Skip to main content

Pain and Psychology

  • Chapter
  • First Online:
Pain Management for Clinicians

Abstract

Pain is a complex emotional and sensory experience that is influenced by biological, psychological, and social factors. The longer pain persists, the more important the psychosocial factors become in the maintenance and aggravation of pain. This chapter describes the rationale for a biopsychosocial approach to pain, including the historical context of the biopsychosocial approach to pain and the state of the current neuroscience research involving psychological factors and pain. Furthermore, relevant psychological constructs when evaluating individuals with chronic pain are explored. Finally, a brief discussion of psychological approaches for pain and interventions based on these approaches is provided.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Institute of Medicine: Committee on Advancing Pain Research C, and Education. Relieving pain in America: a blueprint for transforming prevention, care, education, and research. Washington, D.C.: The National Academies Collection; 2011.

    Google Scholar 

  2. Prevalence of chronic pain and high-impact chronic pain among adults—United States, 2016 [Internet]. 2016.

    Google Scholar 

  3. Gaskin DJ, Richard P. The economic costs of pain in the United States. J Pain. 2012;13(8):715–24.

    Article  PubMed  Google Scholar 

  4. Turk DC, Gatchel RJ. Psychological approaches to pain management: a practioner’s handbook. 2nd ed. New York: The Guilford Press; 2002.

    Google Scholar 

  5. Bushnell MC, Ceko M, Low LA. Cognitive and emotional control of pain and its disruption in chronic pain. Natl Rev. 2013;14:502–11.

    Article  CAS  Google Scholar 

  6. Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC. The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull. 2007;133(4):581.

    Article  PubMed  Google Scholar 

  7. Baum A, Gatchel RJ, Krantz DS. An introduction to health psychology. Boston: McGraw Hill; 1997.

    Google Scholar 

  8. Drossman DA. Functional versus organic: an inappropriate dichotomy for clinical care. Am J Gastroenterol. 2006;101(6):1172–5.

    Article  PubMed  Google Scholar 

  9. Breuer J, Freud S. Studies in Hysteria. New York: Nervous and Mental Disease Publishing; 1937.

    Google Scholar 

  10. Beecher HK. Pain in men wounded in battle. Ann Surg. 1946;123:96–105.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Bingel U. The effect of treatment expectation on drug efficacy: imaging the analgesic benefit of the opioid remifentanil. Sci Transl Med. 2011;3:7–14.

    Article  CAS  Google Scholar 

  12. Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977;196(4286):129–36.

    Article  CAS  PubMed  Google Scholar 

  13. Butler D, Moseley L. Explain pain. Adelaide City West, Australia: Noigroup Publications; 2003.

    Google Scholar 

  14. Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150(3699):971–9.

    Article  CAS  PubMed  Google Scholar 

  15. Gatchel RJ, Robinson RC, Peng YB, Benitez OJ. Pain and the brain: a synthesis of the current understanding of brain response to pain learned from functional magnetic resonance imaging (fMRI). Pract Pain Manag 2011;8(5). https://www.practicalpainmanagement.com/resources/pain-brain

  16. Villemure C, Bushnell MC. Mood influences supraspinal pain processing separately from attention. J Neurosci. 2009;29(3):705–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Siegel DJ. The developing mind: how relationships and the brain interact to shape who we are. 2nd ed. New York: Guilford Press; 2012.

    Google Scholar 

  18. de Charms RC, Maeda F, Glover GH, Ludlow D, Pauly JM, Soneji D, et al. Control over brain activation and pain learned by using real-time functional MRI. Proc Natl Acad Sci. 2005;102(51):1826–31.

    Google Scholar 

  19. Moriarty O, McGuire BE, Finn DP. The effect of pain on cognitive function: a review of clinical and preclinical research. Prog Neurobiol. 2011;93(3):385–404.

    Article  PubMed  Google Scholar 

  20. Tamburin S, Maier A, Schiff S, Lauriola MF, Di Rosa E, Zanette G, et al. Cognition and emotional decision-making in chronic low back pain: an ERPs study during Iowa gambling task. Front Psychol. 2014;5:1350.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Whitlock EL, Diaz-Ramirez LG, Glymour MM, Boscardin WJ, Covinsky KE, Smith AK. Association between persistent pain and memory decline and dementia in a longitudinal cohort of elders. JAMA Intern Med. 2017;177(8):1146–53.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Polatin PB, Kinney RK, Gatchel RJ, Lillo E, Mayer TG. Psychiatric illness and chronic low back pain: the mind and the spine-which goes first? Spine. 1993;18(1):66–71.

    Article  CAS  PubMed  Google Scholar 

  23. Fishbain DA, Cutler RB, Rosomoff HL, et al. Chronic-pain associated depressions: antecedent or consequence of chronic pain? Clin J Pain. 1997;13(3):116–37.

    Article  CAS  PubMed  Google Scholar 

  24. McWilliams LA, Cox BJ, Enns MW. Mood and anxiety disorders associated with chronic pain: an examination in a nationally representative sample. Pain. 2003;106:127–33.

    Article  PubMed  Google Scholar 

  25. Robinson RC. Psychometric testing: the early years and the MMPI. In: Gatchel RJ, Weisberg J, editors. Personality characteristics of patients with pain. Washington, D.C.: American Psychological Association; 2000.

    Google Scholar 

  26. Gatchel RJ, McGeary DD, McGeary CA, Lippe B. Interdisciplinary chronic pain management: past, present, and future. Am Psychol. 2014;69(2):119–30.

    Article  PubMed  Google Scholar 

  27. Fields HL. The doctor’s dilemma: opiate analgesics and chronic pain. Neuron. 2011;69(4):591–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Von Korff M, Kolodny A, Deyo RA, Chou R. Long-term opiod therapy reconsidered. Ann Intern Med. 2011;155:325–8.

    Article  Google Scholar 

  29. Lee M, Silverman SM, Hansen H, Patel VB, Manchikanti L. A comprehensive review of opioid-induced hyperalgesia. Pain Physician. 2011;14(2):145–61.

    PubMed  Google Scholar 

  30. Chou R, Turner JA, Devine EB, Hansen RN, Sullivan SD, Blazina I, et al. The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a national institutes of health pathways to prevention workshop. Ann Intern Med. 2015;162(4):276–86.

    Article  PubMed  Google Scholar 

  31. Robinson RC, Gatchel RJ, Polatin PB, Deschner M, Gajraj N, Noe C. Screening for problematic opioid behavior. Clin J Pain. 2001;17:220–8.

    Article  CAS  PubMed  Google Scholar 

  32. Weir K. New solutions for the opioid crisis: how psychologists improve care. Monit Psychol. 2019;50(6):32–9.

    Google Scholar 

  33. Gatchel RJ, Theodore BR. Evidence-based outcomes in pain research and clinical practice. Pain Pract. 2008;8(6):452–60.

    Article  PubMed  Google Scholar 

  34. Chou R. 2009 clinical guidelines from the American pain society and the American Academy of pain medicine on the use of chronic opioid therapy in chronic noncancer pain: what are the key messages for clinical practice? Pol Arch Med Wewn. 2009;119(7–8):469–77.

    PubMed  Google Scholar 

  35. Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 1994;331(2):69–73.

    Article  CAS  PubMed  Google Scholar 

  36. Fordyce WE. Behavioral methods for chronic pain and illness. St. Louis: C. V. Mosby Co.; 1976.

    Google Scholar 

  37. Gatchel RJ, Robinson RC, Block AR, Benedtto NN. Assessment of pain in primary care settings. In: Maruish ME, editor. Handbook of psychological assessment in primary care settings. Washington, D.C.: Taylor & Francis Ltd; 2017.

    Google Scholar 

  38. Vlaeyen JW, Linton SJ. Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain. 2012;153(6):1144–7.

    Article  PubMed  Google Scholar 

  39. Mior S. Exercise in the treatment of chronic pain. Clin J Pain. 2001;17(4 Suppl):S77–85.

    Article  CAS  PubMed  Google Scholar 

  40. Wandner LD, Prasad R, Ramezani A, Malcore SA, Kerns RD. Core competencies for the emerging specialty of pain psychology. Am Psychol. 2019;74(4):432–44.

    Article  PubMed  Google Scholar 

  41. Taylor SE. Health psychology. 9th ed. New York: Guilford; 2015.

    Google Scholar 

  42. Carver CS, Scheier MF, Fulford D. Self-regulatory processes, stress, and coping. In: John OP, Robins RW, Pervin LA, editors. Handbook of personality theory and research. 3rd ed. New York: Guilford; 2008.

    Google Scholar 

  43. Thinking BAT, Depression. Ii. Theory and therapy. Arch Gen Psychiatry. 1964;10:561–71.

    Article  Google Scholar 

  44. Turk DC, Rudy TE. Assessment of cognitive factors in chronic pain: a worthwhile enterprise? J Consult Clin Psychol. 1986;54(6):760–8.

    Article  CAS  PubMed  Google Scholar 

  45. Lefebvre MF. Cognitive distortion and cognitive errors in depressed psychiatric and low back pain patients. J Consult Clin Psychol. 1981;49(4):517–25.

    Article  CAS  PubMed  Google Scholar 

  46. Sullivan MJ, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA, et al. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain. 2001;17(1):52–64.

    Article  CAS  PubMed  Google Scholar 

  47. Wertli MM, Burgstaller JM, Weiser S, Steurer J, Kofmehl R, Held U. Influence of catastrophizing on treatment outcome in patients with nonspecific low back pain: a systematic review. Spine (Phila Pa 1976). 2014;39(3):263–73.

    Article  Google Scholar 

  48. Mayer TG, Gatchel RJ, Mayer H, Kishino N, Kelley J, Mooney VA. Prospective two-year study of functional restoration in industrial low back pain. JAMA. 1987;258:1181–2.

    Article  Google Scholar 

  49. Speed TJ, Parekh V, Coe W, Antoine D. Comorbid chronic pain and opioid use disorder: literature review and potential treatment innovations. Int Rev Psychiatry. 2018;30(5):136–46.

    Article  PubMed  Google Scholar 

  50. McCracken LM, Vowles KE. Acceptance and commitment therapy and mindfulness for chronic pain: model, process, and progress. Am Psychol. 2014;69(2):178–87.

    Article  PubMed  Google Scholar 

  51. Lumley MA, Schubiner H, Lockhart NA, Kidwell KM, Harte SE, Clauw DJ, et al. Emotional awareness and expression therapy, cognitive behavioral therapy, and education for fibromyalgia: a cluster-randomized controlled trial. Pain. 2017;158(12):2354–63.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Andrasik F, Flor H, Turk DC. An expanded view of psychological aspects in head pain: the biopsychosocial model. Neurol Sci. 2005;26(Suppl 2):s87–91.

    Article  PubMed  Google Scholar 

  53. Veehof MM, Trompetter HR, Bohlmeijer ET, Schreurs KM. Acceptance- and mindfulness-based interventions for the treatment of chronic pain: a meta-analytic review. Cogn Behav Ther. 2016;45(1):5–31.

    Article  CAS  PubMed  Google Scholar 

  54. Sollner W, Schussler G. Psychodynamic therapy in chronic pain patients: a systematic review. Z Psychosom Med Psychother. 2001;47(2):115–39.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Richard C. Robinson .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Robinson, R.C., Chong, J. (2020). Pain and Psychology. In: Noe, C. (eds) Pain Management for Clinicians. Springer, Cham. https://doi.org/10.1007/978-3-030-39982-5_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-39982-5_16

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-39981-8

  • Online ISBN: 978-3-030-39982-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics