Patterns of illness behaviour in patients with intractable pain

Pilowsky, I.; Spence, Neil

doi:10.1016/0022-3999(75)90026-4

Cited by 277 publications

(91 citation statements)

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“…Illness behavior was measured with the Illness Behavior Questionnaire (IBQ) [25], a 62-item scale that measures 7 dimensions of general hypochondriasis, disease conviction, disease perception, affective inhibition, dysphoria, denial, and irritability. Higher scores indicate higher levels of abnormal illness behavior.…”

Section: Methodsmentioning

confidence: 99%

Alexithymia and Cancer Pain: The Effect of Psychological Intervention

Tulipani

Morelli

Spedicato

et al. 2010

Psychother Psychosom

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Background: Alexithymia is likely to be involved in the pain experience of cancer patients, but the extent to which psychological interventions may modify both pain and alexithymia is unclear. Methods: A group of 52 consecutive cancer patients were enrolled in a 6-month multicomponent psychological intervention trial, and compared to 52 control patients who received standard medical care. Validated scales for pain, alexithymia, coping with disease, illness behavior, psychological distress, and psychosocial functioning were administered at baseline and 6 months later. Results: Pain was strongly associated with alexithymia and several psychological dimensions. Although at baseline patients in the intervention group had worse psychological and somatic health, at follow-up their level of pain intensity, alexithymia, and somatic concerns had significantly improved compared to control patients. Patients in the intervention group showed dramatic improvements in pain perception, alexithymia, and other psychological variables, while control patients showed an unexpected significant worsening of alexithymia, depression, and adjustment to disease. Multiple regression showed that psychological intervention and alexithymia were both independently associated with the reduction in pain perception. Conclusions: These findings confirm the close association between alexithymia and pain, and show that multicomponent psychological intervention may significantly reduce both alexithymia and cancer pain. Although the present findings need replication, they should strongly encourage clinicians to provide patients with psychological interventions targeting alexithymic difficulties and helping patients to cope better with both feelings and somatic perception.

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Section: Methodsmentioning

confidence: 99%

Alexithymia and Cancer Pain: The Effect of Psychological Intervention

Tulipani

Morelli

Spedicato

et al. 2010

Psychother Psychosom

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“…O comportamento de doença anormal é desenvolvido como estratégia de comunicação ou meio de adaptação [32][33][34] e para obter ganhos financeiros 33,35 .…”

Section: Visão Sociológicaunclassified

“…Este questionário foi aplicado em pacientes com dor crônica intratável, cuja queixa era desproporcional à patologia , e a pacientes também com sintomas dolorosos proeminentes freqüentando clínicas de reumatologia, radioterapia, pulmonar e fisioterapia. Os resultados revelaram que convicção de doença e ausência de resposta a informações tranquilizadoras do médico caracterizam os pacientes com dor crônica desproporcional à patologia 28,32,36 . Embora a faixa de comportamento de doença normal talvez não seja possível de ser determinada exatamente, a experiência do médico, baseada em dados pessoais e históricos do doente, permite avaliar razoavelmente quando o comportamento está dentro do esperado.…”

Section: Visão Sociológicaunclassified

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Aspectos comportamentais das síndromes de dor crônica

Oliveira

2000

Arq. Neuro-Psiquiatr.

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RESUMO -O conhecimento dos mecanismos biológicos da dor não é suficiente para a compreensão das síndromes de dor crônica frequentemente encontradas pelos neurologistas, como lombalgias, cervicobraquialgias e mialgias, nas quais nenhuma anormalidade significativa é encontrada. Aspectos psicológicos, como distúrbios do humor e ansiedade, e aspectos sociais, como ganhos secundários do tipo aposentadorias e indenizações, podem ter papel relevante na iniciação e perpetuação dos sintomas. Fatores psicológicos e sociais produzem um comportamento de doença anormal, caracterizado basicamente por uma desproporção entre sinais objetivos escassos, queixas exacerbadas e alegação de incapacidade. A identificação de um comportamento de doença anormal, através da observação e avaliação dos comportamentos dos pacientes, é um método válido e útil para fins diagnósticos e quanto a natureza das queixas. O médico deve agir de modo a não reforçar as convicções organicistas dos pacientes, orientando-se quanto à propedêutica e tratamento pelos sinais objetivos e não pelo vigor das queixas e alegação de incapacidade. A sociedade deve também abster-se de adotar políticas que estimulam comportamentos de doente anormais. PALAVRAS-CHAVE: dor crônica, doença, comportamento anormal. Behavioral aspects of chronic pain syndromesABSTRACT -The knowledge of biological pain mechanisms are not sufficient for the understanding of patients with chronic pain syndromes such as low back, cervicobrachial and muscle pain. Psychological and psychosocial aspects play important roles in the setting and perpetuation of symptoms. Mood and anxiety disorders, secondary gains such as early retirement and financial compensations, must all be acknowledged by the physician as possible contributors to the symptoms. Abnormal illness behavior may better characterize patients with chronic pain syndromes. Behavior observation, which is akin to medical practice, is therefore a powerfull tool in the diagnosis and management of these syndromes. Physicians ought be very careful in not reinforcing the patients already strong organic convictions regarding their symptoms, avoiding making decisions based on patients complaints and alleged disabilities, and assigning poorly defined and disputable diagnosis labels. Society needs also to refrain from policies that encourage abnormall illness behaviors.KEY WORDS: chronic pain, abnormal illness behavior.O diagnóstico e o manejo de pacientes com sintomas sem patologia evidente é difícil e a maioria dos médicos não recebe educação e treinamento nesta tarefa 1 , sendo o médico treinado para procurar sempre uma patologia ou disfunção fisiológica responsável pelos sintomas. Por outro lado, explicações não-orgânicas não são aceitas por grande parte dos pacientes [2][3][4][5][6] . Estes fatores levam a uma demanda de rótulos, tanto por médicos quanto por pacientes, de diagnósticos que sugiram bases orgânicas dos sintomas. Diagnósticos surgem, de modo geral associados a algum descobrimento científico mais recente, e desaparecem quando as evid...

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“…Currently, several questionnaires can be used to assess health anxiety: Health Anxiety Questionnaire (HAQ) [8], the Illness Attitude Scales (IAS) [9], the Whiteley Index of hypochondriasis (WI) [10], Short Health Anxiety Inventory (SHAI) [11], Multidimensional Inventory of Hypochondriacal Traits (MIHT) [12], Somatosensory Amplification Scale (SSAS) [13], Illness Behavioral Questionnaire (IBQ) [14] and Minnesota Multiphasic Personality Inventory (MMPI-2) [15]. Only the SHAI was constructed according to the cognitive-behavioral model, whereas MIHT's usefulness seems to be limited.…”

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confidence: 99%

Evaluation of psychometric properties and factor structure of the Polish version of Short Health Anxiety Inventory (SHAI)

Kocjan¹

2016

Arch Psych Psych

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SummaryObjectives: The aim of the study was to adapt the English language version of the Short Health Anxiety Inventory (SHAI) developed by Salkovskis et al. to the Polish language and to investigate its psychometric properties and factor structure in clinical and non-clinical samples.Method: A total of 296 individuals participated in the study: 172 in the clinical sample (46% females and 54% males; mean age: 57.29 ± 13.01 years) and 124 in the non-clinical sample (51% females and 49% males; mean age: 54.45 ± 13.63). They completed the Polish language version of an 18-item SHAI and the Hamilton Anxiety Rating Scale (HAM-A). To assess psychometric properties, internal consistency, test-retest reliability, item-total statistics, construct and convergent validity, an analysis of ROC curves was performed.Results: Both samples had excellent internal consistency (Cronbach's α 0.91 and 0.92) and test-retest reliability (r=0.91 and r=0.94). Correlational analysis revealed a significant relationship of anxiety to SHAI total score and to each of the two SHAI subscales. Factor analysis revealed a two-factors solution, which accounted for 48% and 49% of the variance. A cut-off score of 20 was optimal for detecting a severe form of health anxiety in the clinical and non-clinical sample, providing the best balance between specificity and sensitivity.Discussion: Despite the widespread application of SHAI, a Polish language version has not yet been created. The psychometric properties of the scale confirmed a high reliability and accuracy of the proposed solutions. Conclusions:Our findings confirm that the SHAI-Polish version is a reliable and valid instrument for detecting health anxiety. hypochondriasis, health anxiety, Short Health Anxiety Inventory

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Patterns of illness behaviour in patients with intractable pain

Cited by 277 publications

References 10 publications

Alexithymia and Cancer Pain: The Effect of Psychological Intervention

Alexithymia and Cancer Pain: The Effect of Psychological Intervention

Aspectos comportamentais das síndromes de dor crônica

Evaluation of psychometric properties and factor structure of the Polish version of Short Health Anxiety Inventory (SHAI)

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