What Is Pain?
Signs and Symptoms of Acute and Chronic Pain
Pain is a multisensory experience with sensory and affective components. Sensory components of pain describe where the pain is, what it feels like, and how strong it is. Affective components of pain describe how the pain makes us feel. Therapists working with pain patients also find it helpful to assess and work with the behavioral, cognitive, functional, and social effects of pain.
Psychological Models and Theory of Acute and Chronic Pain
Fear-Avoidance Model of Chronic Pain
The fear-avoidance model of chronic pain (Vlaeyen & Linton, 2000) describes a trajectory followed by individuals experiencing acute pain who may become trapped in a vicious cycle of chronic disability and suffering. As a cognitive model it proposes that the appraisals pain patients form concerning their pain can lead to sequences that end in avoidance, deconditioning, and further pain and suffering. The fear-avoidance model of chronic pain is empirically well-supported but it has been argued that the next generation of the model needs to add motivational components including goals and self-regulatory processes (Crombez et al, 2012).
Acceptance and Commitment Therapy (ACT) Model of Chronic Pain
ACT is a transdiagnostic approach to human difficulties that is popular among clinicians working with pain.
“The basic premise of ACT as applied to chronic pain is that while pain hurts, it is the struggle with pain that causes suffering … continuing attempts to control pain may be maladaptive, especially if they cause unwanted side effects or prevent involvement in valued activities, such as work, family, or community involvement” (Dahl & Lundgren, 2015).
References
Crombez, G., Eccleston, C., Van Damme, S., Vlaeyen, J. W., & Karoly, P. (2012). Fear-avoidance model of chronic pain: The next generation. The Clinical Journal of Pain, 28(6), 475–483.
Dahl, J., & Lundgren, T. (2015). Acceptance and commitment therapy in the treatment of chronic pain. Retrieved from: https://www.div12.org/wp-content/uploads/2015/06/ACT-in-the-treatment-of-chronic-pain.pdf
Vlaeyen, J. W. S., & Linton, S. J. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain, 85(3), 317–332.
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