Journal
JOURNAL OF PAIN
Volume 9, Issue 3, Pages 210-216Publisher
CHURCHILL LIVINGSTONE
DOI: 10.1016/j.jpain.2007.10.013
Keywords
chronic pain; pain assessment; self-criticism
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The experience of pain is influenced by patients' personality, social and cultural background, and patient-doctor interaction. This study examines the role of self-reported pain, pain diagnosis, age, gender, depression, and the personality trait of self-criticism (defined as individuals' tendency to set unrealistically high self-standards and to adopt a punitive stance toward one's self), in determining physicians' view of expected prognosis in response to chronic pain management. Before the first visit to a tertiary chronic pain clinic, patients provided information regarding their perceived pain, depression, and self-criticism. Immediately subsequent to the visit, physicians' evaluated expected prognosis. Participating physicians were blinded to the patient's psychosocial variables collected. Sixty-four patients with chronic pain (34 women and 30 men) with various diagnoses were included. Patients' age, gender, pain diagnosis, self-reported pain, and depression did not significantly correlate with physician's estimation of expected prognosis. In contrast, patients' self-criticism emerged as an independent predictor of physicians' pessimism regarding outcome. Thus, in the chronic pain clinic setting, patients' personality, rather than self-reported pain experience, determines doctor's clinical judgment of expected prognosis. Perspective: Chronic pain is a multimodal negative experience that is determined by physiological, cognitive, personological, and interpersonal factors. in line with this observation, we found patients' personality, specifically, their self-criticism, determines physicians' clinical judgment of expected prognosis. (C) 2008 by the American Pain Society.
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