Value of consensual ratings in differentiating organic and functional low back pain,

Donham, Greg W.; Mikhail, S. F.; Meyers, Robert J.

doi:10.1002/1097-4679(198403)40:2<432::aid-jclp2270400208>3.0.co;2-s

Cited by 2 publications

(3 citation statements)

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“…It should be noted, though, that the perspective that pain can be categorized as either psychogenic or functional is considered outdated and has been shown to have no empirical support (Baum et al, 1997). Donham, Mikhail, and Meyers (1984) found significant relationships between ratings of pain by nurses and high scores on the Social Introversion scale of the MMPI, among others (Table 8.4). Nurses rated patients on whether they experienced "functional" or "organic' ' back pain, with functional pain being designated when clinical evidence is not sufficient to point to underlying organic pathology or when the symptoms reported contradict physical findings.…”

Section: Chronic Pain Conditions and Personalitymentioning

confidence: 87%

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Extraversion–introversion and chronic pain.

Phillips¹,

Gatchel²

2000

Personality Characteristics of Patients With Pain.

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This chapter discusses the way clinical researchers have examined the effects of the extraversion-introversion personality factor on chronic pain. The early research in this area focused on laboratory-induced pain, and although different researchers report different results, the consensus indicated that extraverted individuals are more tolerant of pain and have a higher threshold for pain than do more introverted people. Later studies began to examine pain-either acute pain (such as postoperative pain) or chronic pain-in clinical situations. Although variable results also are reported in those studies, the general findings have suggested that, even though extraverted individuals are more prone to complain about pain, they also paradoxically have a higher tolerance for pain and experience less pain in given conditions than do introverts. This would imply that extraverted patients are not at all shy in complaining about discomfort, even that which could be considered tolerable. It should be pointed out that, as pain becomes chronic, patients are more prone to develop social introversion, which then sensitizes them more to pain sensations. This chapter examines possible reasons for these relationships, and it reviews the importance of considering extraversion-introversion in the clinical management of patients with pain. Early ResearchOver the years, researchers have demonstrated that, although pain often has an organic, physiological basis, there are many other factors that contribute to the experience of pain and a person's reaction to it. These can include environmental and social factors, gender, age, race, marital status, and social support, as well as religious, cultural, and social beliefs. For example, one early review (Bond, 1971) cites the work of several investigators, such as Exton-Smith (1961), who found that older people tend to experience less pain than do younger people who have similar conditions; Merskey and Spear (1967) found that race affects both the threshold for pain and the degree of complaining associated with pain. They also found that the threshold for pain appears to be generally higher in men than in women. Bond and Pilowsky (1966) reported that, in clinical settings, the attitudes that nursing staff members have toward a patient's pain appear to affect complaint behavior. Finally, social support affects pain, with postsurgical patients who have supportive families showing lower pain associated with surgery (Gil, Ginsberg, Muir, Sullivan, &Williams, 1992). People seem to recover more quickly when they are able to call on family members and friends for support (Williams, 1996).Emotional state and innate personality characteristics also affect individual re-The writing of this chapter was supported in part by National Institutes of Health grants DE 10713-05 and MH 46452-05 to the second author.

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Section: Chronic Pain Conditions and Personalitymentioning

confidence: 87%

“…Research suggests that some individuals are more predisposed than others to experience symptoms of pain (Donham et al, 1984). Sternbach (1977) noted that many processes are involved in the complaint of pain, including physical and psychosocial processes, which are equally likely to play a part in the experience of pain.…”

Section: Discussionmentioning

confidence: 99%

Extraversion–introversion and chronic pain.

Phillips¹,

Gatchel²

2000

Personality Characteristics of Patients With Pain.

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“…From the time of the pioneering work of Hanvik in 1951, there has grown a consistent literature that shows that those patients whose back pain is deemed "functional" exhibit significantly higher elevations of the neurotic triad (scales 1, 2 and 3), often in a "conversion V" pattern, when compared with patients with organic back pathology (Calsyn, Louks, & Freeman, 1976;Donham, Mikhail, & Meyers, 1984;Freeman, Calsyn, & Louks, 1976;Gentry, Newman, Goldner, & Von Baeyer, 1977) or with other organic problems (Chaney, Williams, Cohn, & Vincent, 1984;Naliboff, Cohen, & Yellen, 1982). Other MMPI scales occasionally have been related to nonorganic low back pain (Calsyn et al, 1976;Chaney et a]., 1984; Donham et al, 1984;Hanvik, 1951;Snibbe et al, 1980;Thomas & Lyttle, 1976), as have derived scales, notably the Lb (low back) and Dor scales (Dorsalles func-tionalles). However, the data on MMPI scales other than 1, 2 and 3, and on the derived scales, have been less consistent.…”

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confidence: 99%

Predictors of outcome in back surgery candidates

et al. 1988

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This study employed a prospective design to examine the value of three demographic, three orthopaedic, and four psychometric variables as predictors of orthopaedic and rehabilitation outcome in 116 Workers' Compensation patients seriously considered for first lumbar surgery, separately for the 14 who eventually did undergo surgery, and the 42 who did not. The two groups differed only with respect to the number of Nonorganic Physical Signs, but a complex pattern of predictive relationships emerged, in which orthopaedic outcome was generally easier to predict than rehabilitation outcome. Among the demographic factors, level of English proficiency was the best predictor and correlated positively with orthopaedic outcome in both surgery and non-surgery cases and with rehabilitation outcome in non-surgery patients. The Nonorganic Physical Signs test emerged as the predictor of choice and correlated with orthopaedic outcome in both groups and with rehabilitation outcome in the non-surgery group. Scale 1 of the MMPI correlated with orthopaedic outcome in both groups and Scale 3 with both orthopaedic and rehabilitation outcome, but only in the non-surgery patients.

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Value of consensual ratings in differentiating organic and functional low back pain,

Cited by 2 publications

References 19 publications

Extraversion–introversion and chronic pain.

Extraversion–introversion and chronic pain.

Predictors of outcome in back surgery candidates

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