Do Acute and Chronic Pain Patients Differ on Affirmation of One Aspect of Pain Acceptance? Acknowledgement that a Cure Is Unlikely.

Background: Many chronic pain patients (CPPs) cannot be cured of their pain, but can learn to manage it. This has led to research on pain "acceptance" which is defined as a behavior pattern with awareness of pain but not directed at changing pain.

Objective: CPPs who have accepted their pain generally acknowledge that a cure is unlikely.

The Psychological Evaluation of Patients with Chronic Pain: a Review of BHI 2 Clinical and Forensic Interpretive Considerations.

Pain is the most common reason why patients see a physician. Within the USA, it has been estimated that at least 116 million US adults suffer from chronic pain, with an estimated annual national economic cost of $560-635 billion. While pain is in part a sensory process, like sight, touch, or smell, pain is also in part an emotional experience, like depression, anxiety, or anger.

Prevalence comparisons of somatic and psychiatric symptoms between community nonpatients without pain, acute pain patients, and chronic pain patients.

Objectives: Somatic/psychiatric symptoms are frequently found in chronic pain patients (CPPs). The objectives of this study were to determine 1) which somatic/psychiatric symptoms are more commonly found in acute pain patients (APPs) and CPPs vs community nonpatients without pain (CNPWPs) and 2) if somatic/psychiatric symptom prevalence differs between APPs and CPPs.

Design: The above groups were compared statistically for endorsement of 15 symptoms: fatigue, numbness/tingling, dizziness, difficulty opening/closing mouth, muscle weakness, difficulty staying asleep, depression, muscle tightness, nervousness, irritability, memory, falling, nausea, concentration, and headaches.

Examination of symptom clusters in acute and chronic pain patients.

Background: Symptom clusters have not been previously explored in acute pain patients (APPs) and chronic pain patients (CPPs) with non-cancer pain.

Objectives: The objectives of this study were to determine in CPPs and APPs which somatic and non-somatic symptoms cluster with each other, the number of clusters, and if cluster number and cluster symptom makeup differ by pain level.

Study Design: Study sample was 326 APPs and 341 CPPs who had completed a pool of questions that had included current symptom questions other than pain.

Exploring the Relationship of Three Medical Entitlement Beliefs and Psychiatric/Psychological Variables for Acute and Chronic Pain Patients.

Objectives: The belief in medical care entitlement has recently resulted in major changes in the medical system in the United States. The objectives of this study were the following: to compare endorsement of three medical entitlement beliefs (I deserve the best medical care no matter what the cost [BMC], I am entitled to all of the medical care I want at no charge [NC], I shouldn't have to wait to see my doctors [W]) in community nonpatients without pain (CNPWP), acute pain patients (APPs), and chronic pain patients (CPPs) and to develop predictor models for these beliefs in APPs and CPPs.

Design: CNPWP, APPs, and CPPs were compared statistically for frequency of endorsement of each belief.

Exploration of affirmation of childhood molestation (sexual abuse) in chronic pain patients, acute pain patients, community patients with pain and community nonpatients without pain.

Objectives: To further explore the controversy as to whether childhood molestation is associated with chronic pain in adulthood.

Design: Community nonpatients without pain (CNPWP), community patients with pain (CPWP), acute pain patients (APPs), and chronic pain patients (CPPs) were compared for endorsement of affirmation of childhood molestation by chi-square. Logistic regression was utilized to predict affirmation in male and female CPPs.

The prevalence of smokers within chronic pain patients and highest pain levels versus comparison groups.

OBJECTIVES.: The objectives of this study were to (1) compare the prevalence of smoking within chronic pain patients (CPPs) to community non-patients without pain (CNPWP), community patients with pain (CPWP), and acute pain patients (APPs); and (2) compare smokers to nonsmokers within CPPs, APPs, and CPWP for highest pain level. DESIGN.

Exploration of anger constructs in acute and chronic pain patients vs. community patients.

Objectives: (1) Determine and compare prevalence of forms of anger (FOA; anger, hostility, aggression, anger-in, anger-out, chronic anger) in community nonpatients (n=478), community patients (n=158), acute pain patients (APPs; n=326), chronic pain patients (CPPs; n=341); and (2) develop FOA predictor models in APPs and CPPs.

Design: A large set of items containing the FOA items was administered to the above groups, who were compared statistically for FOA endorsement. APPs and CPPs affirming the anger and chronic anger items were compared with those not affirming on all available variables including the Battery for Health Improvement (BHI-2) with significant variables (P≤0.

Exploration of the illness uncertainty concept in acute and chronic pain patients vs community patients.

Objective: Illness uncertainty (IU) theory proposes that patients with chronic illness may have difficulty adjusting to the illness if there is significant diagnostic or prognostic uncertainty. Two dimensions of IU theory are "lack of information about diagnoses or severity of the illness" (LIDSI) and "complexity regarding the health care system" (CRHCS). The primary objective of this study was then to compare the prevalence of IU in community nonpatients, community patients, and rehabilitation patients without pain/chronic pain patients (CPPs)/acute pain patients (APPs) as represented by two items with possible face validity for LIDSI ("doctors puzzled by my problems,""doctors missed something important") and three items with possible CRHCS face validity ("doctors don't believe me,""I need to prove my problem is real,""doctors think my problems are in my head").

Variables associated with self-prediction of psychopharmacological treatment adherence in acute and chronic pain patients.

Objectives: The objectives of this article were the following: (1) determine risk for self-predicted future psychopharmacological nonadherence in rehabilitation acute pain patients (APPs) and rehabilitation chronic pain patients (CPPs) vs. pain-free community controls and community patients, and (2) determine which variables predict nonadherence.

Design: The Battery for Health Improvement 2 was developed utilizing a healthy (pain-free) community sample (N = 1,478), a community patient sample (N = 158), and a rehabilitation patient sample (N = 777) of which 326 were APPs, 341 were CPPs, and 110 were patients without pain.

Borderline personality disorder features and pain: the mediating role of negative affect in a pain patient sample.

Objectives: There is considerable evidence that personality disorders, including borderline personality disorder (BPD), tend to co-occur with chronic pain. There is also evidence that mood disorders co-occur with chronic pain conditions. Given the central role of affective instability and negative mood states in BPD, we proposed that affective features of depression, anxiety, and hostility may account for the association between BPD features and the severity of pain reported in a patient sample.

What variables are associated with an expressed wish to kill a doctor in community and injured patient samples?

Working in a health care setting has been identified as a primary risk factor for violent assault, which is often perpetrated by patients. Patient dangerousness is a multidimensional phenomenon, which may include violent ideation, homicidal planning, a history of violent acts, or overt threatening behavior. Although the verbal report of thoughts of killing a doctor is only one of many risk factors for patient dangerousness, reports of homicidal ideation are widely regarded as being sufficient to warrant concern, and to indicate a need for further assessment of the patient.

Correlates of self-reported violent ideation against physicians in acute--and chronic-pain patients.

Objectives: Physicians are at risk for patient-perpetrated violence. This study attempts to identify predictors for violent ideation against medical doctors (VI-MD), in acute-pain patients (APPs) and chronic-pain patients (CPPs). This is the first such study in the literature.

Assessment of biopsychosocial risk factors for medical treatment: a collaborative approach.

There is a growing body of evidence that psychosocial variables have a significant ability to predict the outcome of medical treatment procedures, especially when the procedure is performed to reduce pain. The study described in this paper serves as an illustration of the valuable role psychologists can play in dealing with the challenges of biopsychosocial assessment of patients who are candidates for medical treatments, especially elective, invasive procedures. Based on a convergent model of risk factors that can potentially influence outcomes from spinal surgery and spinal cord stimulation, exclusionary and cautionary risk factors were identified, and the BHI 2 and BBHI 2 tests were used to assess them.

What are the variables that are associated with the patient's wish to sue his physician in patients with acute and chronic pain?

Objectives: Although there is limited research on patient attributes that may be related to reasons for launching a malpractice suit, no such research has been performed in acute pain patients (APPs) or chronic pain patients (CPPs). The objective of this study was then to develop some statistical models that would describe such patients' attributes.

Methods: A statement about having thoughts of suing a physician (sue medical doctor [MD]) is the focus of this study, and was contained within the Battery for Health Improvement (BHI) research version (BHI-R).

Chronic pain and violent ideation: testing a model of patient violence.

Objective: Physicians are at risk of patient-perpetrated violence. The objective of this study was to test a clinical model of patient violence, which had been developed previously by Fishbain and colleagues. The developers of this model believed that it would be associated with increased risk of violence in pain patients.

Chronic nonmalignant pain and violent behavior.

Research suggests that violence has entered the medical setting to a remarkable degree, causing medical professionals to be at the highest risk for becoming the victims of assaults and violent acts. This article reviews general theories of aggression and research on these theories, and uses them to assess risk factors in patients with chronic pain. There are data to suggest that pain may increase the risk of aggressiveness in some patients.