Pain behavior concepts and controversies
This article summarizes recent research on pain behavior observation and highlights a number of controversial issues involved in applying this approach to the assessment of chronic pain patients. The article is divided into two major sections. In the first section, a number of observation methods used to record pain behavior in standardized situations and naturalistic settings are described. The reliability and validity of these observation methods, and their advantages and disadvantages, are discussed. The second section addresses five criticisms of the pain behavior construct. These criticisms include: the pain behavior construct is too simplistic, the focus on pain behavior denies the existence of pain, the questions of whether pain behavior is an expression of pain or a coping response, the measures of pain behavior may not be useful in clinical settings, and the notion that pain behavior has been oversold. The criticisms are evaluated from a behavioral perspective and the discussion highlights the potential utility of the pain behavior construct. The paper concludes with suggestions for future research. © 1992.
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