Cognitive-processing bias in chronic pain: a review and integration.
Do patients with chronic pain selectively process pain- and illness-related stimuli? The evidence with regard to attention, interpretation, and recall biases is critically reviewed. A model is proposed to account for the findings in which it is suggested that biases in information processing in chronic pain are the result of overlap between 3 schemas: pain, illness, and self. With frequent repeated or continued experience of pain, the pain schema becomes enmeshed with illness and self-schemas. The extent of the enmeshment and the salient content of the schema determine the bias. A fundamental assumption is that all patients with pain selectively process sensory-intensity information. A clinical implication of the results is that processing biases that extend beyond this healthy and adaptive process to enmesh the self-schema with pain and illness schemas could maintain and exacerbate distress and illness behavior in patients with chronic pain.
Pincus
T
T
Department of Psychology, Royal Holloway, University of London, Egham, United Kingdom. t.pincus@rhul.ac.uk
Morley
S
S
D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D001288:Attention; D002908:Chronic Disease; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D006801:Humans; D010146:Pain / Q000523:psychology*; D012649:Self Concept; D012803:Sick Role