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The development of two-stage screening for mental illness and abnormal illness behaviour in pain clinic patients
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ROLE OF THE CHRONIC PAIN PATIENT'S SPOUSE IN THE MAINTENANCE OF PAIN BEHAVIORS. K.J. ~gan1,*,3 and R. Ixtlahauc3*, Depts of 1RehabilitationMedicine and ZPsychiatry and Behavioral Science and 3University of Washington School of Medicine, Seattle, WA 98195, USA. Aim of investigation: Although the spouse of the pain patient appears to play an important role in the maintenance of the patient's pain behaviors and sick role, little research attention has been directed toward them; this study was designed to explore the history of the spouses with respect to their own pain problems; illness and disability in their family of origin; and their responses to their suffering spouses. Methods: Thirty-eight spouses of patients being evaluated at a multidisciplinary pain center were interviewed using a structured interview, the SCL-90, and the Symptom Response Questionnaire. Results: Sixty-one percent of the spouses were experiencing a chronic pain problem that interfered significantlywith their functioning and 47% of their children were also said to have a chronic pain problem, typically abdominal or headache. Seventy-two percent of the spouses, during childhood or an earlier marriage, had had previous responsibility for caring for a disabled parent or spouse. Spouses reported these actions in response to the patient's pain: taking over that person's jobs around the house, giving sympathy, massaging and bringing medication. Conclusions: The findings suggest that the spouse's own experience with pain and with care-taking of prior chronic patients may contribute to their solicitous responses and willingness to continue to support the chronic pain patient's disability; if spouses are expected to be supportive of pro-health changes in pain patients, then prior learning experiences and expectations must be taken into consideration in treatment planning.
ROLE OF THE CHRONIC PAIN PATIENT'S SPOUSE IN THE MAINTENANCE OF PAIN BEHAVIORS. K.J. ~gan1,*,3 and R. Ixtlahauc3*, Depts of 1RehabilitationMedicine and ZPsychiatry and Behavioral Science and 3University of Washington School of Medicine, Seattle, WA 98195, USA. Aim of investigation: Although the spouse of the pain patient appears to play an important role in the maintenance of the patient's pain behaviors and sick role, little research attention has been directed toward them; this study was designed to explore the history of the spouses with respect to their own pain problems; illness and disability in their family of origin; and their responses to their suffering spouses. Methods: Thirty-eight spouses of patients being evaluated at a multidisciplinary pain center were interviewed using a structured interview, the SCL-90, and the Symptom Response Questionnaire. Results: Sixty-one percent of the spouses were experiencing a chronic pain problem that interfered significantlywith their functioning and 47% of their children were also said to have a chronic pain problem, typically abdominal or headache. Seventy-two percent of the spouses, during childhood or an earlier marriage, had had previous responsibility for caring for a disabled parent or spouse. Spouses reported these actions in response to the patient's pain: taking over that person's jobs around the house, giving sympathy, massaging and bringing medication. Conclusions: The findings suggest that the spouse's own experience with pain and with care-taking of prior chronic patients may contribute to their solicitous responses and willingness to continue to support the chronic pain patient's disability; if spouses are expected to be supportive of pro-health changes in pain patients, then prior learning experiences and expectations must be taken into consideration in treatment planning.