Stigmatization of Patients with Chronic Pain: The Extinction of Empathy

Cohen, Milton; Quintner, John; Buchanan, David; Nielsen, Mandy; Guy, Lynette

doi:10.1111/j.1526-4637.2011.01264.x

Cited by 129 publications

(90 citation statements)

References 46 publications

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“…Given that professional healthcare providers have insufficient knowledge about the nature of chronic nonmalignant pain [75], or report feeling less effective and uncertain when treating patients with chronic pain [63], the first step would be to enhance knowledge of chronic pain through pain education [5,8,39,57]. Extending the narrow biomedical perspective on acute pain to the comprehensive biopsychosocial model would compel consideration of a broader range of determinants of pain related disability [2,5].…”

Section: A C C E P T E Dmentioning

confidence: 99%

Understanding stigma and chronic pain: a-state-of-the-art review

Ruddere

Craig

2016

Pain

255

242

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Chronic nonmalignant pain makes individuals prone to stigmatizing reactions of others.Stigmatizing responses are devaluing and discrediting responses of observers toward individuals who possess a particular characteristic that deviates from societal norms [16]. In the context of chronic nonmalignant pain, an absence of clear tissue damage deviates from the widely held biomedical model, which presumes that clear physiological pathology underlies the pain experience [22]. As well, most people understand pain through acute pain experience, which resolves relatively rapidly over time, leading to uncertainty about pain that does not diminish [48,63]. These and other processes must be understood to explain the substantial evidence that individuals with chronic pain commonly suffer from stigmatization by others [32].The stigma associated with chronic pain are not well understood, with research lacking accounts of determinants, including underlying mechanisms in stigmatizing persons and details concerning vulnerabilities and the impact on stigmatized persons. Furthermore, prevention strategies for teaching how to deal with others' stigmatizing reactions and programs aimed at minimizing stigmatizing behaviors of observers are scarce. This topical review briefly describes the current understanding of stigma attached to chronic pain and has the intent to provide some thought provoking ideas and highlight future directions that will inspire both researchers and clinicians. 2.Stigma and chronic pain Stigma perceived by the patientAbundant evidence highlights the ubiquity of stigma in the lives of individuals with chronic pain [1,21,25,26,32,34,52,54,55,62,73,74,76] Impact of stigma on the wellbeing of pain patientsAlthough thorough research into the consequences of both perceived stigma and public stigma on the wellbeing of pain patients is lacking, preliminary evidence shows that the discounting A C C E P T E D A C C E P T E Dexploited by others [35]. In particular, the absence of a clear medical explanation for the pain might function as a threat for the observer regarding availability of reciprocity (i.e., the social exchange) to be expected from individuals in pain [35].There is a substantial literature demonstrating that individuals stigmatize individuals from the "out group" [58]. "In group" people include those similar to the observer, e.g., kin, friends, age peers, whereas "out group" people likely include those with different skin colors, ideological persuasions, etc. In the context of pain, observers feel less empathy and less altruistic motivation towards members of social out-groups than members of in-groups [29,47] and the pain complaints of "out group" members tend to be discounted [65]. This is consistent with findings that observers attribute lower pain to patients who are considered responsible for their pain condition [17,68].A final useful explanatory approach arises from the considerable research which indicates that healthcare practitioners often feel uncertain or unprepared to manage patients with c...

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Section: A C C E P T E Dmentioning

confidence: 99%

Understanding stigma and chronic pain: a-state-of-the-art review

Ruddere

Craig

2016

Pain

255

242

View full text Add to dashboard Cite

show abstract

“…to the scientific literature (Bove 2008, Bove 2009, Quintner and Bove 2001, Cohen et al 2013, Cohen et al 2011, Quintner et al 2008. In this paper, they criticize the hypothesis of TrP formation as put forth initially by Simons and Travell, and later modified by others (Gerwin et al 2004, Simons 1996, McPartland 2004, McPartland and Simons 2006.…”

Section: Quintner Bove and Cohen Have Made Significant Contributionsmentioning

confidence: 90%

A critical evaluation of Quintner et al: Missing the point

Dommerholt¹,

Gerwin

2015

Journal of Bodywork and Movement Therapies

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“…Chibnall et al [29] found that between-physician consistency was very low for the diagnosis of CP. Due to the lack of specific diagnostic tests to assess the organic pathology of CP, patients may even be labelled as somatizers or even malingerers [30,31]. Chronic pain patients often feel that the absence of a discernible diagnosis implies that health professionals feel that the pain may just be in their minds [32].…”

Section: Discussionmentioning

confidence: 99%