Biogenic, Psychogenic, and Sociogenic Models of Adjustment to Chronic Pain: An Exploratory Study

Abstract

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. Method: 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.