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Journal of Rational-Emotive & Cognitive-Behavior Therapy

Gepubliceerd in:

01-03-2010 | Original Article

Maladaptive Cognitions and Chronic Pain: Epidemiology, Neurobiology, and Treatment

Auteur: Jonathan M. Borkum

Gepubliceerd in: Journal of Rational-Emotive & Cognitive-Behavior Therapy | Uitgave 1/2010

Abstract

Maladaptive cognitions are widespread and play a significant role in the development of chronic pain. (1) Catastrophizing seems to increase the risk of chronicity. In the laboratory it amplifies temporal summation of pain with repeated stimulation and delays the disengagement of attention from pain. In neuroimaging it is associated with increased activation in regions of the cortex involved in attention, the aversiveness of pain, and possibly pain intensity. (2) Fearful anticipation of pain seems to pre-activate brain regions involved in both the sensory and emotional intensity of pain and primes a stronger initial pain response. It may lead to abnormal patterns of muscle recruitment that, speculatively, may predispose to injury. (3) Belief that normal activity should be avoided seems to promote unnecessary long-term disability in nonspecific low back pain. Extreme guarding may intensify pain through loss of inhibition from motor cortex. (4) Educational programs targeting maladaptive beliefs have shown benefit in the primary prevention of chronic back pain in both pain-free and acute pain populations. In established chronic pain, cognitive-behavioral therapy has shown efficacy in improving pain intensity, coping and pain behaviors when compared with usual treatment. (5) Possible future research directions and clinical implications are discussed.

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Titel: Maladaptive Cognitions and Chronic Pain: Epidemiology, Neurobiology, and Treatment
Auteur: Jonathan M. Borkum
Publicatiedatum: 01-03-2010
Uitgeverij: Springer US
Gepubliceerd in: Journal of Rational-Emotive & Cognitive-Behavior Therapy / Uitgave 1/2010
Print ISSN: 0894-9085
Elektronisch ISSN: 1573-6563
DOI: https://doi.org/10.1007/s10942-010-0109-x

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