Abstract
Pain in organic disease has anatomical, physiological and psychological components which are inseparably linked, but there does not appear to be a strict relationship between the nature and apparent severity of noxious stimulation and the point at which different individuals experience pain. Moreover, in any group of patients at the same stage of an illness known to be associated with pain, some complain whereas others do not. Many factors are known to influence pain and complaint behaviour. The elderly experience less pain than younger patients with similar disorders (Exton-Smith, 1961). Pain thresholds tend to be lower in women than men, and racial differences are significant when considering both thresholds and complaint behaviour (Merskey and Spear, 1967). Pain may not be immediately associated with wounding in the physical and emotional struggles of battle, and the later intensity of suffering has been shown to be related to the significance of the wound to the patient (Beecher, 1956). There is an increase in pain in the presence of anxiety (Kennard, 1952; Masson, 1966) and Cole (1965) reported that factors associated with persistent pain include a disagreeable environment, a long history of pain, anxiety, depression, poor general health, resentment and lack of confidence in the doctor. Complaint behaviour is regarded by some as a learned response developed in childhood (Schilder, 1935; Russell, 1962; Sarbin, 1962; Simpson and others 1965). Bond and Pilowsky (1966) have demonstrated that in a clinical setting differences in complaint behaviour between the sexes depend in part upon the attitudes of nursing staff towards pain.
Publisher
Royal College of Psychiatrists
Subject
Psychiatry and Mental health
Cited by
109 articles.
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