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. 2005;4(1):11–18. doi: 10.1016/S0899-3467(07)60107-4

Practitioner Perceptions of Emotions Associated with Pain: A Survey

Scott Walker a, Peter Bablis a, Henry Pollard b,*, Andrew McHardy a
PMCID: PMC2647028  PMID: 19674641

Abstract

Objective

To discover whether chiropractors consider that emotional factors are associated with pain presentations in their patients and if so, what methods they use to investigate these factors and what strategies they use to manage them.

Design

A telephone survey of chiropractors in Australasia (Australia and New Zealand) and North America (America and Canada). A database of practitioners was obtained for each region. A phoning protocol was established in each region to standardize the survey approach.

Setting

Private practice of chiropractic.

Method

Chiropractic centers were telephoned and the attending chiropractor(s) were asked to complete a phone survey. The survey consisted of a series of short questions designed to establish the main techniques used in the practice. Questions focused on whether emotional factors of the patient were recognized and addressed and what role emotional factors play in the management of the patient.

Sample

Subjects were registered/licensed chiropractors listed in a publication of the largest association of practitioners in their region.

Results

In Australasia and North America just under half of practitioners surveyed (45.8% and 50.5% respectively) used a technique to evaluate any impacting emotions on the presenting condition. Additionally, 36.3% of Australasia and 33.3% of North America practitioners had a technique to treat emotional factors in the patient. The study also suggests that over 90% of Australasian chiropractors and 80% of North America chiropractors consider emotional factors important in pain presentations.

Conclusion

This study found that a substantial number (80–90%) of the chiropractors surveyed believe that emotional factors influence pain syndromes. However, less than half of these practitioners report that they are able to evaluate emotional factors and approximately only a third report that they are able to treat them. This study shows there is a need for further research of chiropractors to be able to evaluate emotional factors and techniques that can be used to rectify emotional components of their patients' pain syndromes.

Key Indexing Terms: Chiropractic, Psychology, Emotion, Biopsychosocial Model

Footnotes

Sources of Support: This study was supported by a research grant from the ONE Foundation, a research foundation dedicated to Neuro-Emotional Technique (NET), Encinitas, California, USA.

References

  • 1.Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977;196:129–136. doi: 10.1126/science.847460. [DOI] [PubMed] [Google Scholar]
  • 2.Buselli EF, Stuart EM. Influences of psychosocial factors and biopsychosocial interventions on outcomes after myocardial infarction. J Card Nurs. 1999;13:60–72. doi: 10.1097/00005082-199904000-00006. [DOI] [PubMed] [Google Scholar]
  • 3.Hemingway H, Marmot M. Evidence based cardiology: psychosocial factors in the aetiology and prognosis of coronary heart disease: systematic review of prospective cohort studies. BMJ. 1999;318:1460–1467. doi: 10.1136/bmj.318.7196.1460. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4.Kawachi I, Colditz GA, Ascherio A, Rimm EB, Giovannucci E, Stampfer MJ. Prospective study of phobic anxiety and risk of coronary heart disease in men. Circulation. 1994;89:1992–1997. doi: 10.1161/01.cir.89.5.1992. [DOI] [PubMed] [Google Scholar]
  • 5.Kawachi I, Sparrow D, Vokonas PS, Weiss ST. Symptoms of anxiety and risk of coronary heart disease. The Normative Aging Study. Circulation. 1994;90:2225–2229. doi: 10.1161/01.cir.90.5.2225. [DOI] [PubMed] [Google Scholar]
  • 6.Drossman DA. Editorial: gastrointestinal illness and the biopsychosocial model. J Cl Gastro. 1996;22:252–254. doi: 10.1097/00004836-199606000-00002. [DOI] [PubMed] [Google Scholar]
  • 7.Drossman DA. Gastrointestinal illness and the biopsychosocial model. Psych Med. 1998;60:258–267. doi: 10.1097/00006842-199805000-00007. [DOI] [PubMed] [Google Scholar]
  • 8.Schneiderman N, Antoni MH, Saab PG, Ironson G. Health psychology: psychosocial and biobehavioral aspects of chronic disease management. Ann Rev Psychol. 2001;52:555–580. doi: 10.1146/annurev.psych.52.1.555. [DOI] [PubMed] [Google Scholar]
  • 9.Pincus T, Burton K, Vogel S, Field AP. A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine. 2002;27:E109–E120. doi: 10.1097/00007632-200203010-00017. [DOI] [PubMed] [Google Scholar]
  • 10.Kiecolt-Glaser JK, Page GG, Marucha PT, MacCallum RC, Glaser R. Psychological influences on surgical recovery: perspectives from psychoneuroimmunology. Am Psychol. 1998;53:1209–1218. doi: 10.1037//0003-066x.53.11.1209. [DOI] [PubMed] [Google Scholar]
  • 11.Kiecolt-Glaser JK, McGuire L, Robles TF, Glaser R. Emotions, morbidity, and mortality: new perspectives. Ann Rev Psychol. 2002;53:83–107. doi: 10.1146/annurev.psych.53.100901.135217. [DOI] [PubMed] [Google Scholar]
  • 12.Linton SJ. A review of psychological risk factors in back and neck pain. Spine. 2000;25:1148–1156. doi: 10.1097/00007632-200005010-00017. [DOI] [PubMed] [Google Scholar]
  • 13.Pincus T, Vlaeyen J, Kendall N, Von Korff M, Kalauokalani D, Reis S. Cognitive-behavioral therapy and psychosocial factors in low back pain. Spine. 2002;27(5):E133–E138. doi: 10.1097/00007632-200203010-00020. [DOI] [PubMed] [Google Scholar]
  • 14.Pincus T, Burton A, Vogel S, Field A. A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine. 2002;27:E109–E120. doi: 10.1097/00007632-200203010-00017. [DOI] [PubMed] [Google Scholar]
  • 15.Foster NE, Pincus T, Underwood MR, Vogel S, Breen A, Harding G. Understanding the process of care for musculoskeletal conditions— why a biomedical approach is inadequate. Rheumatol (Oxford) 2003;42:401–404. [PubMed] [Google Scholar]
  • 16.Campbell LC, Clauw DJ, Keefe FJ. Persistent pain and depression: a biopsychosocial perspective. Biol Psychiatry. 2003;54:399–409. doi: 10.1016/s0006-3223(03)00545-6. [DOI] [PubMed] [Google Scholar]
  • 17.Burton AK, Waddell G, Tillotson KM, Summerton N. Information and advice to patients with back pain can have a positive effect. A randomized controlled trial of a novel educational booklet in primary care. Spine. 1999;24:2484–2491. doi: 10.1097/00007632-199912010-00010. [DOI] [PubMed] [Google Scholar]
  • 18.Brewin CR. Theoretical foundations of cognitive-behavior therapy for anxiety and depression. Annu Rev of Psychol. 1996;47:33–57. doi: 10.1146/annurev.psych.47.1.33. [DOI] [PubMed] [Google Scholar]
  • 19.Chambless DL, Gillis MM. Cognitive therapy of anxiety disorders. J Consult Cl Psychol. 1993;61:248–260. doi: 10.1037//0022-006x.61.2.248. [DOI] [PubMed] [Google Scholar]
  • 20.Dobson KS. A meta-analysis of the efficacy of cognitive therapy for depression. J Consult Cl Psychol. 1989;57:414–419. doi: 10.1037//0022-006x.57.3.414. [DOI] [PubMed] [Google Scholar]
  • 21.Linton SJ, Andersson T. Can chronic disability be prevented? A randomized trial of a cognitive-behavioral intervention for spinal pain patients. Spine. 2000;25:2825–2831. doi: 10.1097/00007632-200011010-00017. [DOI] [PubMed] [Google Scholar]
  • 22.Hollon SD, Shelton RC, Davis DD. Cognitive therapy for depression: conceptual issues and clinical efficacy. J Consult Cl Psychol. 1993;61:270–275. doi: 10.1037//0022-006x.61.2.270. [DOI] [PubMed] [Google Scholar]
  • 23.Stedman's concise medical dictionary. 4th Ed. Lippincot, Williams & Wilkins; Baltimore: 2001. p. 914. [Google Scholar]
  • 24.McQuaid JR, Stein MB, Laffaye C, McCahill ME. Depression in a primary care clinic: the prevalence and impact of an unrecognized disorder. J Affect Disord. 1999;55:1. doi: 10.1016/s0165-0327(98)00191-8. 1. [DOI] [PubMed] [Google Scholar]
  • 25.Fink P, Sorensen L, Engberg M, Holm M, Munk-Jorgensen P. Somatization in primary care. Prevalence, health care utilization, and general practitioner recognition. Psychosomatics. 1999;40:330–338. doi: 10.1016/S0033-3182(99)71228-4. [DOI] [PubMed] [Google Scholar]
  • 26.Wilson T. Applications of the SF-36 Health Survey. J Rehab Outcomes Measure. 1997;1:26–34. [Google Scholar]
  • 27.Levy HI, Hanscom B, Boden SD. Three-question depression screener used for lumbar disc herniations and spinal stenosis. Spine. 2002;27:1232–1237. doi: 10.1097/00007632-200206010-00017. [DOI] [PubMed] [Google Scholar]
  • 28.Dworkin RH, Von Korff M, LeResche L. Multiple pains and psychiatric disturbance: an epidemiologic investigation. Arch Gen Psychiatry. 1990;47:239–344. doi: 10.1001/archpsyc.1990.01810150039007. [DOI] [PubMed] [Google Scholar]
  • 29.Nakao M, Yamanaka G, Kuboki T. Major depression and somatic symptoms in a mind/body medicine clinic. Psychopath. 2001;34:230–235. doi: 10.1159/000049315. [DOI] [PubMed] [Google Scholar]
  • 30.American Psychiatric Association . Diagnostic and statistical manualof mental disorders (DSM-IV) 4th ed. American Psychiatric Association; Washington, DC: 1994. [Google Scholar]
  • 31.Zaza C, Baine N. Cancer pain and psychosocial factors: a critical review of the literature. J Pain Symptom Manage. 2002;24:526–542. doi: 10.1016/s0885-3924(02)00497-9. [DOI] [PubMed] [Google Scholar]

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