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Unformatted text preview: Acta Anaesthesiol Scand 2001; 45 : 1095–1099 Copyright C Acta Anaesthesiol Scand 2001 Printed in Denmark. All rights reserved ACTA ANAESTHESIOLOGICA SCANDINAVICA ISSN 0001-5172 Review Article Psychological issues in cancer and non-cancer conditions M . R. BOND University of Glasgow, Glasgow, Scotland The mechanism whereby incoming noxious stimuli result in emotional and behavioural changes is centred within cognitive processes. The mechanism is activated for all forms of pain but variations in the emotions generated and coping styles and strategies adopted occur. They are related to each individual’s appraisal of their pain and the condition giving rise to it – major differences in appraisal relate to the presence or absence of ma- lignancy with its potential threat to life. The psychological treat- ments of cognitive behavioural therapy have a role in the man- agement of all chronic pain but historically have been employed more in non-cancer pain conditions than in patients with cancer T HREE ISSUES are addressed in this paper. First, are there similarities in the mechanisms responsible for the emotional and behavioural aspects of pain in cancer and non-cancer conditions? Second, are there different patterns of emotional behaviour in the two groups of disorders with respect to pain and third, how does our knowledge of emotion and behaviour in the two sets of disorders relate to psychological treatments and their availability? Psychological distress is, in broad terms, a charac- teristic of all pain but the nature of the emotional pat- terns included in it vary and in particular with whether the pain is acute or chronic. The significance of the underlying condition that gives rise to pain, for example whether it is due to cancer or a non-cancer condition, has a significant effect on emotion. Where it is present, the extent of tissue damage is not necess- arily proportional to the pain experienced or the be- haviour associated with it. In certain situations, emotional distress or conflict alone may give rise to pain in the absence or near absence of physical rea- sons for its presence. In other words, pain may be- come the basis of a somatoform disorder, that is, one in which psychological and social difficulties are rep- resented as physical symptoms with varying but as- sociated levels of disability. 1095 pain. In the United Kingdom, the facilities for the treatment of pain by cognitive behavioural therapy are very limited and for that reason counselling, long used in aiding cancer patients, is likely to remain the main form of psychological treatment in that group. Key words: Non-cancer pain; cancer pain; biopsychosocial model; cognitive processes; emotional and behavioural outputs; cognitive behavioural therapy....
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- Spring '11
- Psychology, acute pain, Suffering