Psychological factors in chronic pain: assessment and treatment issues

This article presents an overview of psychological factors which influence chronic pain. Emphasis is placed on assessment techniques and psychological treatment approaches for patients with chronic pain. In the first section, the usefulness of psychometric measures are discussed and areas considered critical in the psychological assessment of chronic pain are reviewed, including (1) pain intensity, (2) functional capacity, (3) mood and personality, (4) pain beliefs and coping, (5) medication usage, (6) adverse effects, (7) behavioral analysis, and (8) health care utilization. Personality factors affecting pain syndromes, DSM-IV diagnoses and health care utilization issues are also discussed. In the second section, an overview of psychological and behavioral interventions for chronic non-malignant pain are presented within the context of a multi-disciplinary pain management program. A rationale for a group-based program along with roles of a team, program goals, patient selection criterion, components of the program, and information on program evaluation is reviewed.