Showing papers by "Tamar Pincus published in 2001"
TL;DR: It is suggested that biases in information processing in chronic pain are the result of overlap between 3 schemas: pain, illness, and self, and 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.
Abstract: 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.
471 citations
TL;DR: In this paper, the authors investigated the relationship between recall bias for pain stimuli in chronic low back pain patients and the cost of managing their back pain in primary care, and found that a minority of patients high on recall bias were found to account for a disproportionate amount of the cost.
Abstract: Objectives. To investigate the relationship between recall bias for pain stimuli in chronic low back pain patients and the cost of managing their back pain in primary care.
Design. A retrospective cross-sectional investigation.
Method. A sample of 63 low back pain patients were interviewed in a primary care setting. Information was gathered on their pain intensity, disability ratings, depression, anxiety, and duration of pain. They were also presented with a surprise recall test for pain descriptors. The cost of each patient's treatment specifically for back pain in the previous 12 months was calculated. The relationship between the cost of back pain treatment and the scores from the interview were calculated first for total cost, and then for the breakdown of individual cost items.
Results. Results indicated that recall bias for pain stimuli were significantly related to total cost (R2 = 8%). A detailed analysis revealed that pain intensity was related to the number of appointments with the general practitioners; depression scores related to the number of appointments with the in-house osteopaths; and recall bias for pain stimuli related to referrals to external experts (out-patients). A minority of patients high on recall bias was found to account for a disproportionate amount of the cost.
Conclusion. Although no causal path can be deduced from the findings, the study provides a novel approach to measuring psychological factors in back pain in reference to health care utilization. It is limited by its retrospective design, and should be followed by prospective studies to understand fully the relationship between cognitive bias and utilization of health services.
32 citations