Psychological factors

1. Discuss the psychological factors associated with pain and, at least, one psychosocial intervention used to treat pain.

Psychological factors related to pain disorder get viewed to play a significant role in the onset, seriousness, exacerbation or maintenance of the pain. Psychological assessment assists in understanding patient’s experience of pain together with any associated pain behavior such as grimacing, postural changes and expressions of face. It also assists in identifying coping strategies that get used by the patient and whether they result in a positive outcome such as distraction and staying busy or adverse outcome such as catastrophising and limitation of activity. The diagnosis of pain disorder with psychological factors gets made when the patient’s reaction is out of proportion to the physical condition and when deficits in psychosocial functioning occur.

The psychological factors associated with pain include (Turk & Gatchel, 2013).

1. Cognitions: Fear about paralysis and despondency can result in elevated levels of pain.
2. Emotion: High levels of pain get associated with fear, anxiety, general stress and depression. High levels of these aspects compel individuals to seek medical treatment for the pain.
3. Behavior: Pain gets associated with low self-esteem as well as marked avoidance
4. Attention: Giving a particular pain lot of attention can result in elevated intensity.
5. Interpretation: Pain gets assessed differently by different patients, for instance, an individual who suffered a heart attack may ignore a muscle twitch in the chest.
6. Expectations: The type of expectation an individual has towards a particular pain may affect the feedback received from pain receptors.
7. Context: The time when pain is occurring determines the pain felt by a person, for instance, a patient who has got injected with anesthesia in a theater surgery procedure may not feel the pain until later.
8. Coping approaches: Different approaches get used to minimize pain. They include biofeedback, visualization, positive affirmations, and distraction.

Cognitive-Behavioral Therapy for Pain Management

This psychosocial treatment process involves several phases. The first step in treatment is pain education, where a patient gets explained about pain, how the role of own response towards pain influences pain experience and coping strategies in pain control. The second step involves in one or more coping skills for pain management. The therapist provides an educational rationale, basic instruction as well as guided practice and feedback got each strategy taught. The third step involves home practice with the skills learned from the therapist. The last step of treatment involves assisting patients to establish a program for maintaining their skills practice after the completion of training and for overcoming setbacks and relapses in the coping strategies.

2. Pick two of the five theoretical models of coping with chronic illness and describe in detail. What adherence interventions would be effective in the two models you choose?

Self-Regulation Model

It is a theoretical model of goal-directed behavior that gets applied to understanding people’s ability to cope with the chronic disorder. In this model, the human behavior gets influenced by objectives through which individuals seek to develop particular desired conditions in their lives. Patients use the self-realization process to strive to achieve certain goals. This model gets based on the assumption that patients experience stress when they get hindrances towards achieving their goals and dealing with stress gets conceptualized as efforts at self-regulation based on that adversity. Suffering from a chronic illness is stressful to the extent that it gets viewed to prevent a patient’s goals and their ability to deal successfully with the disease get determined by their capacity to reassess the goals (Suls, Davidson & Kaplan, 2010).

Self-Determination Model

It is a theoretical model based on a broader theory of human motivation and behavior referred to as self-determination theory. The theory assumes that humans have three natural psychological needs namely, autonomy, competence, and relatedness to others and when these needs get met; persons usually experience improved self-motivation, development, and well-being. The theory recognizes that behavioral and affective factors of coping with chronic diseases such as diabetes and hypertension get facilitated by self-management. According to this model, people’s motivations for autonomy and competence are vital in successfully coping with chronic illnesses. Autonomy motivation occurs when individuals experience volition and choice in their illness-related behaviors, whereas competence occurs when patient’s feel that they can control important disease-related outcomes (Suls, Davidson & Kaplan, 2010).

References

Suls, J. M., Davidson, K. W., & Kaplan, R. M. (Eds.). (2010). Handbook of health psychology and behavioral medicine. Guilford Press. p. 490-511

Turk, D. C., & Gatchel, R. J. (Eds.). (2013). Psychological approaches to pain management: A practitioner's handbook. Guilford Publications.

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