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Pain syndromes involve a complex interaction of medical and
psychological factors. In each syndrome unique physiological
mechanisms are mediated by emotional states, personality traits,
and environmental pressures to determine the nature and extent of
pain complaints and pain-related disability. The Handbook addresses
the complexities of chronic pain in three ways.
Section I describes general concerns that cross-cut the different
syndromes, such as the use of narcotic pain medications, the
detection of deception and malingering, and the epidemiology of
pain. Section II presents comprehensive reviews of a wide range of
pain syndromes. Each covers basic pathophysiology, psychological
factors found to influence the course of the syndrome, and
syndrome-specific multidisciplinary treatment approaches. Most of
the Section II chapters are coauthored by psychologists and
physicians. Section III discusses pain in special populations,
including the elderly and children.
The "Handbook" is the most up-to-date, comprehensive, and
integrated single-volume resource for all those professionally
concerned with pain.
Pain syndromes involve a complex interaction of medical and
psychological factors. In each syndrome unique physiological
mechanisms are mediated by emotional states, personality traits,
and environmental pressures to determine the nature and extent of
pain complaints and pain-related disability. The Handbook addresses
the complexities of chronic pain in three ways. Section I describes
general concerns that cross-cut the different syndromes, such as
the use of narcotic pain medications, the detection of deception
and malingering, and the epidemiology of pain. Section II presents
comprehensive reviews of a wide range of pain syndromes. Each
covers basic pathophysiology, psychological factors found to
influence the course of the syndrome, and syndrome-specific
multidisciplinary treatment approaches. Most of the Section II
chapters are coauthored by psychologists and physicians. Section
III discusses pain in special populations, including the elderly
and children. The Handbook is the most up-to-date, comprehensive,
and integrated single-volume resource for all those professionally
concerned with pain.
Pain is an unfortunate daily experience for many individuals.
Chronic pain -- lasting six or more months -- is suffered by
approximately 30% of the population in the United States. These
individuals wake up, function during the day and go to sleep,
trying to keep pain at a minimum while, at the same time,
maintaining some quality of life. They may make frequent visits to
the doctor and the pharmacy. When they find relief, it is usually
short-lived and comes at a cost such as dependence on narcotic
medications or complete limitation of activity. Pain often becomes
the central point of their existence.
This practice guide describes an approach to psychological
evaluation of the chronic pain patient who is being considered for
surgery. A large body of research is accumulating which
demonstrates that the outcome of surgical procedures aimed at
chronic pain relief can be strongly influenced by psychological and
emotional factors. This approach, termed "presurgical psychological
screening" (PPS) uses interview and testing techniques to identify
emotional, behavioral, and psychosocial difficulties which have
been demonstrated to negatively impact surgical outcome. Studies
show that even patients with clearly identifiable pathophysiology
may respond poorly to surgery, due to issues such as pain
sensitivity, medication dependence, rewards for pain behavior and
personality style. Thus, some insurance carriers, rehabilitation
nurses and state worker's compensation systems are encouraging, or
even requiring, presurgical psychological screening in cases of
surgery designed to relieve chronic pain.
The first to present a comprehensive, unified approach to PPS in
chronic pain syndromes, this text is designed to provide the
behavioral health practitioner, as well as the trainee, with all
the tools and information necessary to conduct PPS evaluations. It
identifies a multitude of risk factors for poor surgical outcome
and reviews research associated with each risk factor. Hands-on
techniques for eliciting information from the patient about risk
factors is also detailed. Toward this end, the practice guide also
contains a number of forms and session outlines which can be
directly utilized, or which can be altered to fit readers' needs.
Models for weighing and combining surgical outcome risk factors are
also provided. Thus, practitioners are able to reach valid and
reliable predictions of surgical results. Finally, the text
provides outlines of psychological interventions which can
facilitate surgical outcome as well as surgical treatment
alternatives. Upon completion of this practice guide, readers
should be able to begin providing PPS evaluations which are
scientifically valid, clinically sound, and which result in
significant overall improvement in the treatment of chronic pain
syndromes.
Pain is an unfortunate daily experience for many individuals.
Chronic pain -- lasting six or more months -- is suffered by
approximately 30% of the population in the United States. These
individuals wake up, function during the day and go to sleep,
trying to keep pain at a minimum while, at the same time,
maintaining some quality of life. They may make frequent visits to
the doctor and the pharmacy. When they find relief, it is usually
short-lived and comes at a cost such as dependence on narcotic
medications or complete limitation of activity. Pain often becomes
the central point of their existence. This practice guide describes
an approach to psychological evaluation of the chronic pain patient
who is being considered for surgery. A large body of research is
accumulating which demonstrates that the outcome of surgical
procedures aimed at chronic pain relief can be strongly influenced
by psychological and emotional factors. This approach, termed
"presurgical psychological screening" (PPS) uses interview and
testing techniques to identify emotional, behavioral, and
psychosocial difficulties which have been demonstrated to
negatively impact surgical outcome. Studies show that even patients
with clearly identifiable pathophysiology may respond poorly to
surgery, due to issues such as pain sensitivity, medication
dependence, rewards for pain behavior and personality style. Thus,
some insurance carriers, rehabilitation nurses and state worker's
compensation systems are encouraging, or even requiring,
presurgical psychological screening in cases of surgery designed to
relieve chronic pain. The first to present a comprehensive, unified
approach to PPS in chronic pain syndromes, this text is designed to
provide the behavioral health practitioner, as well as the trainee,
with all the tools and information necessary to conduct PPS
evaluations. It identifies a multitude of risk factors for poor
surgical outcome and reviews research associated with each risk
factor. Hands-on techniques for eliciting information from the
patient about risk factors is also detailed. Toward this end, the
practice guide also contains a number of forms and session outlines
which can be directly utilized, or which can be altered to fit
readers' needs. Models for weighing and combining surgical outcome
risk factors are also provided. Thus, practitioners are able to
reach valid and reliable predictions of surgical results. Finally,
the text provides outlines of psychological interventions which can
facilitate surgical outcome as well as surgical treatment
alternatives. Upon completion of this practice guide, readers
should be able to begin providing PPS evaluations which are
scientifically valid, clinically sound, and which result in
significant overall improvement in the treatment of chronic pain
syndromes.
The success of many surgical procedures depends not only on the
skill of the surgeon and the use of state-of-the-art technology,
but also on the actions and characteristics of the patient.
Patients' emotional and psychosocial concerns, health-related
behaviours, outcome expectations, and compliance with treatment
regimen can all strongly influence the ultimate effectiveness of
surgery. Thus, mental health professionals are increasingly called
upon to perform presurgical psychological screening (PPS) to ensure
that patients are given the treatments most likely to be effective,
while reducing the chances of worsening their conditions. This book
presents PPS procedures for a wide range of surgery types, such as
spinal surgery, organ transplantation, bariatric surgery, and
plastic surgery. Drawing on both research and clinical experience,
the authors explain how to conduct PPS, communicate results to
patients and surgeons, and identify possible pre- or post-surgery
interventions to mitigate risk factors and maximise the likelihood
of surgical success. Case studies and a discussion of bioethics are
included
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