Abstract

Background and aims In the spring of 2019, Professor Steven J. Linton, the founder of the Center for Health and Medical Psychology (CHAMP) at Örebro University, Sweden, formally retired. As a tribute to his scholarly work covering decades of influence and inspiration to the field of pain psychology, the research center organized a topical conference titled "Pain in the 21st century: Where do we come from and where are we going?", which resulted in this state-of the-art synthesis. The aim of this declaration is to highlight lessons learned but not in the least is meant to inspire and guide our continued journey forward, developing pain psychology into the 21st century. Methods Several collaborators of Professor Linton have summarized and reflected on the current state-of-the-art of pain psychology from the perspective of his input to the field, as well as on developments from the last years of advancements in pain psychology. Results The topics have been divided into six themed sections covering the fear avoidance model, transdiagnostics, secondary prevention, risk- and protective factors, communication and contextual factors. The sections cover a broad spectrum, from basic experimental studies, integrating emotion and motivational theories into current theoretical models, to applied research on the effect of early interventions as well as sophisticated emotion-focused treatment models for pain patients with concurrent emotional ill-health. Conclusions There have been major advancements within pain psychology research during the last decades, moving the field towards a more comprehensive picture, taking emotional and motivational aspects into account to understand pain sufferers. Although psychologically informed interventions in general mainly focus on the individual, it has been put forward that pain management is highly influenced by the surrounding environment, including communication with health care providers, and the occupational and social context. Implications Professor Steven J. Linton has been at the forefront of pain psychology research during the last decades, and inspired by his work this journey will continue into the 21st century, with the ultimate goal of enhancing the understanding and treatment for all people suffering from persistent and disabling pain.

Highlights

  • The field of pain psychology has taken significant steps forward during the last decades

  • Psychologically informed interventions in general mainly focus on the individual, it has been put forward that pain management is highly influenced by the surrounding environment, including communication with health care providers, and the occupational and social context

  • Linton has been at the forefront of pain psychology research during the last decades, and inspired by his work this journey will continue into the 21st century, with the ultimate goal of enhancing the understanding and treatment for all people suffering from persistent and disabling pain

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Summary

Introduction

The field of pain psychology has taken significant steps forward during the last decades. Linton was involved in refining the fear-avoidance model, today one of the most influential theoretical frameworks in clinical pain psychology [2,3,4] This model has inspired major treatment advancements, not least by introducing exposure in vivo as a method to increase the activity levels of patients. Professor Linton has been involved in developing exposure methodology from early pilot trials [5, 6], to recent sophisticated attempts to integrate exposure in vivo with contemporary communication skills and emotion regulation training [7] These are only a few examples of the major contributions that Linton has made to the field of clinical pain psychology. We expect that these motivational and social factors will attract more attention in the near future

New measures and definitions of avoidance
The bidirectionality hypothesis
Emotion regulation
Future directions
The family
The workplace
The community
T he social systems
Conclusion
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