Psychological Findings in Chronic Anal Pain

Abstract

The psychological characteristics of 21 patients suffering from chronic anal pain were studied. They underwent a clinical interview and completed the Eysenck personality questionnaire, the Zung self-rating depression scale and an analogue scale for the assessment of perceived pain. Data derived from the self-rating scales were compared with those obtained from a matched control group afflicted with fissure-in-ano. The pain patients reported higher scores for neuroticism, psychoticism, depression and perceived pain than the controls. Fifty percent of the experimental group had suffered prior to the onset of pain from depressive disturbances, and 11 subjects reported at the clinical interview somatic symptoms which usually accompany depression. These results support the hypothesis that the pain symptom in some patients with chronic anal pain could represent the manifestation of an underlying depressive disturbance.

Neuroticism and selective encoding and recall of symptoms: Evidence from a combined concurrent-retrospective study.

“…Recent empirical studies in medical settings have reached the similar conclusion that patients who overreport somatic complaints are likely to exhibit personality characteristics associated with N (Barsky & Klerman, 1983;Chaturvedi & Bhandari, 1989;deLeon, Saiz-Ruiz, Chinchilla, & Morales, 1987;Jensen, 1988;Katon, Ries, & Kleinman, 1984;Magni, DeBertolini, Doli, & Infantino, 1986;Pilowski, Smith, & Katsikitis, 1987;Quill, 1985;Slavney, Teitelbaum, & Chase, 1985;Smail, 1970).…”

“…In reviewing this history, Zoccolillo and Cloninger (1986) discussed how in 1682 Syndenham concluded that somaticizers exhibit the personality characteristics of dysphoria and labile mood, in 1902 Kraepelin suggested that somaticizers have a disturbance of "emotional attitude," and in 1909 Savil wrote that somaticizers exhibit a marked emotional instability. Recent empirical studies in medical settings have reached the similar conclusion that patients who overreport somatic complaints are likely to exhibit personality characteristics associated with N (Barsky & Klerman, 1983;Chaturvedi & Bhandari, 1989;deLeon, Saiz-Ruiz, Chinchilla, & Morales, 1987;Jensen, 1988;Katon, Ries, & Kleinman, 1984;Magni, DeBertolini, Doli, & Infantino, 1986;Pilowski, Smith, & Katsikitis, 1987;Quill, 1985;Slavney, Teitelbaum, & Chase, 1985;Smail, 1970).…”

Cognitive vulnerabilities predict medical outcome in a sample of pain patients

“…For example, in addition to consistent findings that chronic pain patients have unusually high rates of depression, anxiety, and other psychological disorders that can be regarded as secondary to the painful state, chronic pain patients also tend to have histories of psychological disorders that predate pain onset and tend to meet diagnostic criteria for personality disorders: by definition personality disorders have early onset (usually late adolescence), are chronic, and for these reasons may be presumed to predate pain onset in most cases (Fishbain et aZ., 1986;Magni et aL, 1986). Similarly, as a group, chronic pain patients have consistently been observed to have higher scores on measures of 'neuroticism' and other variables that define vulnerability to psychopathology (Moosbrugger & Schermelleh-Engel, 1991; Wade et aZ., 1992): scores on measures of neuroticism and related constructs are correlated with pain and affect ratings in response to painful stimulation (Affleck et al, 1992;Harkins et al, 1990;Tondo & Gill, 1975).…”