Biogenic, psychogenic, and sociogenic models of adjustment to chronic pain: an exploratory study.
OBJECTIVE
Based upon three models of etiology and adjustment in CLBP, predictions were made about the variables that were expected to differentiate organic and nonorganic patients, including: psychological distress (anxiety, depression, stress, alienation), pain condition and treatment, and general health.


METHODS
Patients from a medical school orthopedic clinic with an organic (N = 58) or a nonorganic (N = 33) diagnosis for chronic low back pain (CLBP) were compared on medical, psychological and sociodemographic variables.


RESULTS
Nonorganic patients exhibited greater emotional distress, contrary to the biogenic model, and nonorganic patients did not exhibit more somatic complaints, contrary to the psychogenic model. Both patterns were consistent with the sociogenic model; nonorganic patients were more distressed, but not because of a greater tendency to somatize. Moreover, modeling was not supported as an explanation of the pain and distress among these patients.


CONCLUSIONS
Social anomie may explain why patients without a medically diagnosable cause for their pain are more psychologically distressed.
Loyola College Center for Social and Community Research Johns Hopkins University School of Medicine, Baltimore, Maryland.
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M
Peyrot
P M
PM
Moody
H J
HJ
Wiese
D000223:Adaptation, Psychological; D000328:Adult; D001416:Back Pain / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D010348:Patient Care Team; D011602:Psychophysiologic Disorders / Q000523:psychology*; D012803:Sick Role; D012931:Social Environment; D013001:Somatoform Disorders / Q000523:psychology*