Assessment of Psychosocial and Functional Impact of Chronic Pain

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Highlights

  • The rationale for a biopsychosocial perspective is presented.

  • The role of emotional and physical functioning, coping, expectation, and sleep are described.

  • Psychosocial and behavioral consequences of persistent pain are discussed.

  • Dimension 4 of the American Pain Society Taxonomy (ie, psychosocial and functional consequences) is described.

  • Methods to assess these factors for the classification of chronic pain are reviewed.

Abstract

The psychosocial and functional consequences of chronic pain disorders have been well documented as having significant effects on the experience of pain, presentation to health care providers, responsiveness to and participation in treatment, disability, and health-related quality of life. Thus, psychosocial and functional consequences have been incorporated as 1 of the 5 dimensions within the integrated Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION)-American Pain Society (APS) Pain Taxonomy (AAPT): 1) core diagnostic criteria; 2) common features; 3) common medical comorbidities; 4) neurobiological, psychosocial, and functional consequences; and 5) putative neurobiological and psychosocial mechanisms, risk factors, and protective factors. In this article we review the rationale for a biopsychosocial perspective, on the basis of current evidence, and describe a set of key psychosocial and behavioral factors (eg, mood/affect, coping resources, expectations, sleep quality, physical function, and pain-related interference with daily activities) that are important consequences of persistent pain and that should be considered when classifying patients within the comprehensive AAPT chronic pain structure. We include an overview of measures and procedures that have been developed to assess this set of factors and that can be used as part of the comprehensive assessment and classification of pain and to address specific research questions.

Perspective

Psychosocial and functional consequences are important considerations in the classification of individuals with chronic pain. A set of key psychosocial and behavioral factors (eg, mood/affect, coping resources, expectations, sleep quality, physical function, and pain-related interference with daily activities) that should be considered when classifying patients within the comprehensive classification of chronic pain disorders developed by the AAPT are outlined and examples of assessment methods for each are described.

Key words

Biopsychosocial
classification
physical function
beliefs
mood
fatigue
sleep
social support
taxonomy

Cited by (0)

The views expressed in this article are those of the authors, none of whom has financial conflicts of interest relevant to the specific issues discussed. No official endorsement by the U.S. Food and Drug Administration (FDA) or the pharmaceutical and device companies that have provided unrestricted grants to support the activities of the ACTTION public-private partnership with the FDA should be inferred. Financial support for this supplement and for the development of the AAPT has been provided by the ACTTION public-private partnership, which has received research contracts, grants, or other revenue from the FDA, multiple pharmaceutical and device companies, and other sources. A complete list of current ACTTION sponsors is available at: http://www.acttion.org/partners.