Psychosocial factors that can influence the self-assessment of function.
What has plagued the evaluation process in this area has been the level of agreement in the wide variation in the measures used to document a construct such as pain, as well as changes in that construct as reflected in the measurement of function. The present article reviews the major psychosocial barriers to assessment/recovery that have been implicated as influencing the self-assessment of function. The following are discussed: secondary gain; secondary loss; emotional distress (such as anger, anxiety and depression); psychopathology; somatization and symptom magnification; compliance and resistance; patient comprehension/mental status; and iatrogenic effects.
Gatchel
Robert J
RJ
Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd., Dallas, Texas 75390-9044, USA. robert.gatchel@utsouthwestern.edu
D000786:Anger; D001007:Anxiety / Q000523:psychology; D002908:Chronic Disease; D003863:Depression / Q000523:psychology; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology*; D006801:Humans; D016743:Mental Competency; D010146:Pain / Q000523:psychology* / Q000534:rehabilitation*; D010349:Patient Compliance; D013001:Somatoform Disorders / Q000523:psychology; D014942:Workers' Compensation