Growing evidence suggests how individuals cope with and appraise
disease-related pain, such as arthritis or cancer, is related not only to their
experience with pain but also to their physical and psychological functioning,
according to new research presented at the American Pain Society’s annual
scientific meeting.
In his presentation at the scientific meeting, Francis J. Keefe, PhD,
professor of psychiatry and behavioral sciences and associate director for
research in the Duke Pain and Palliative Care Initiative at Duke University
Medical Center, described the conceptual background for research on pain coping
and appraisal, especially in disease-related pain and provided an in-depth
evaluation of key themes on pain coping that have emerged from important recent
research studies.
“We are clearly observing that studies of coping do help us better
understand variations in pain and disability,” Keefe said in a press
release. “It’s important to remember that any type of pain has both
mental and physical components to it. What seems to be especially important in
comprehending persons with disease-related pain is catastrophizing, or the
tendency to focus on and exaggerate the threat value of painful stimuli and
negatively evaluate one’s own ability to deal with pain. We already know
that pain catastrophizing is key to understanding chronic pain.”
Keefe documented how daily diary studies are yielding critical new
insights into a greater understanding of individual differences in pain coping
and how treatment can alter the day-to-day relationship between pain and
coping, or mood, noting that personal data assistants (palm-held devices like
smart phones) may offer an effective platform for assessment and ultimately
treatment.
“More definitive research is needed on pain mechanisms underlying
coping,” Keefe concluded. “In a recent study of cortical responses to
pain and the relationship to catastrophizing, it was evident that a cortical
vigilance network is engaged during mild pain, but with more intense pain, a
diminished prefrontal cortical modulation impedes disengaging from and
suppressing pain. Understanding these underlying mechanisms can help to develop
more effective and specific pain therapies in the future.”
Eating and smoking are pain coping efforts that seem to be
self-defeating.
“Increasing food intake may provide acute relief of pain and
distress but it creates long-term problems such as weight gain, increased pain,
inflammation and disability.”
Keefe summarized the expanding body of literature and study results for
coping with disease-related pain.
“Developing and refining interventions to enhance pain coping can
lead to major advances, including pain prevention, an improvement in the
quality of life and reducing the suffering of many individuals having
disease-related pain. I believe there is even more important progress that lies
ahead,” Keefe said.
