Multimethod Assessment of Chronic Pain. Psychology by Paul Karoly

By Paul Karoly

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Location, intensity, and quality,) at the same time as he or she processes emotional (distress-related) features. However, what determines which aspects of pain are processed further (paid attention to) so as to enter focal awareness? T o answer this, we move to the third italicized term from the foregoing quotation, the notion of a reference standard (also referred to more broadly as a schema, prototype, or script). As Leventhal and Ever hart (1979) have claimed: Once an individual is no longer naive regarding pain, a noxious stimulus will retrieve and be integrated with the schematic memory of earlier pain experiences.

T h e procedure is accompanied by a slowly increasing deep pain ". . similar to that of many pathological pains" (Sternbach, 1983, p. 27). T h e patient is asked to continue to operate the hand exerciser and indicate when the induced ischemic pain matches his or her clinical pain level. T h e patient is then asked to continue until pain tolerance is reached. This procedure produces three pain measures: (a) clinical pain level (the elapsed time in seconds for the patient to indicate that the ischemic pain matches the clinical pain); (b) pain tolerance (the time it takes the patient to indicate that he or she has reached the limit of tolerance); and (c) tourniquet pain ratio (the clinical pain level divided by the pain tolerance and then multiplied by 100).

39). Physicians require an organizing framework to both acquire and evaluate the utility of the data collected through interview, physical examination, and stateof-the-art laboratory testing. Knowledge of pathophysiology and its relation to mechanisms of sensory transmission and the use of pain classification schemes assist the physician in making sense of patients' pain problems. 26 The Biomedical Context The Acute-Chronic 27 Distinction Unquestionably, the most frequent differentiation between types of pain involves the labels acute and chronic.

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