Psychological events are both risk factors in, and consequences of, chronic pain

Abstract

This study questioned 2 assumptions often inherent in psychogenic explanations of pain: (1) that a relationship exists between pain and life events predating pain onset, and (2) that pain patients are a psychologically homogeneous group. Chronic pain sufferers in multiple settings and control subjects participated in this study in which the relationships between pain and 20 psychological variables were examined. Pain was defined and assessed in 3 different ways: (1) membership in a pain group, (2) number of specialists consulted for pain, and (3) pain intensity. Of the 20 psychological variables examined, only less emotional repression and greater “ergomania” (excessive work) were consistently associated with pain on all 3 pain criteria. In addition, pain patients were more likely to have had a relative with pain. Comparisons of pain patients in different settings showed that pain clinic patients reported having been more active throughout their lives, but were currently more depressed and experienced less life satisfaction than patients who were not in a specialized pain centre. These results are interpreted in the light of current multicausal views of pain and conclusions are drawn about the role of psychological variables both as risk factors in, and as consequences of pain.