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Target ‘mental defeat’ to treat chronic pain

U. WARWICK (UK) — Healthcare workers should be on the alert for signs of mental defeat in chronic pain patients as it can increase risks of depression and anxiety, research shows.

The concept of mental defeat has previously been associated with post-traumatic stress disorder, but this study applies it to the experience of chronic pain.

Mental defeat occurs when pain patients view their pain as an “enemy” that takes over their life and removes their autonomy and identity.

The study, published in the Clinical Journal of Pain, analyzed three groups of individuals living in Hong Kong—people with chronic pain who had sought specialist treatment, people with chronic pain who did not require specialist treatment, and people with acute pain.

The chronic pain individuals reported pain in a variety of sites, with the majority in both groups identifying back pain as their predominant complaint.

The researchers monitored levels of mental defeat through how much the participants agreed with statements such as “because of the pain I felt destroyed as a person” and “I felt humiliated and that I was losing my sense of inner dignity.”

When the two groups of individuals with chronic pain were compared, those who were seeking specialist treatment for their pain were found to have higher levels of mental defeat than those who did not require such treatment.

Both chronic pain groups had higher levels of mental defeat than the acute pain group.

The study also found that people who had a sense of mental defeat because of pain also reported higher levels of depression and anxiety as well as a higher incidence of the pain interfering with their daily lives.

Cross-cultural phenomenon

The findings of the Hong Kong study reflect earlier studies carried out in the United Kingdom, which suggests that mental defeat is common across cultures.

“The presence of mental defeat in both Western and Eastern populations suggests that aspects of the psychological impact of pain on people’s sense of self and identity are shared across geographical boundaries,” says Nicole Tang of the department of psychology at the University of Warwick, the study’s lead author.

“We know from work in the UK that mental defeat is a significant factor differentiating chronic patients who thrive despite pain from those who develop high levels of distress, depression, and interference from pain in their every-day lives.

“These findings suggest that early screening for mental defeat can predict whether a patient will go on to suffer from severe anxiety and depression. Standard group pain management programs do not have a treatment component targeting the sense of mental defeat.”

“The current development of multidisciplinary pain management services in Hong Kong presents an opportunity to address this gap with a view towards enhancing overall treatment effectiveness.”

Source: University of Warwick

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4 Comments

  1. Richard Posner

    I just hate article about chronic pain treatment that don’t address the underlying issue: pain! Gee, people who hurt all the time are depressed! What a surprise. And what a study about chronic pain in Hong Kong has to do with US pain patients is marginal at best. Anyone with a decent college education knows there are wide cultural variations in the experience of pain.

    Chronic pain patients face treatment providers who belittle, minimize, ignore and otherwise side-step the central issue at hand. Health care providers are now under attack from government agencies who are determined to turn off the supply of effective pain medication to patients because of ‘abuse’ and ‘accidental deaths’. If someone steals my meds, how am I at fault? And I suspect that some of these so-called accidental deaths are simply suicide by overdose of people whose pain has been under-treated for years.

    How about we focus on more effective treatments? How about we quit blaming the patient for not getting better? How about we show some humanity to those who suffer every hour of every day of their lives?

    I’ll tell you one thing, as a chronic pain patient for nearly twenty years: until you’ve suffered as the millions like me have, quit telling me what to do, quit managing my health care by remote control, quit passing laws and issuing regulations that interfere with the relationship between me and my provider. And for politicians and ‘experts’ who insert themselves into the issue, unless you know something about pain, shut the **** up!

  2. D K

    WOW I so agree. Who cares. another stupid report, experiment. addresses nothing to do with the real suffering we all experience with chronic pain. I too am so sick of these studies that do nothing to help me in my daily life. No kidding we suffer from mental defeat. Have you ever lived with this kind of pain day in and day out. I could have told people this! just ask we cant tell you about mental defeat and how it affects us. Most of this “mental defeat” Is caused by the general misconceptions of chronic pain and how it affects people on a daily level. DUH. Ya exactly SHut the @@@@ up!

  3. JW

    I agree with both previous comments!! I have had pain for over twenty years also. I am getting more isolated by the day because I can’t participate in things the way I used to. I used to go to pain specialists, but now I’ve setteled for what my primary care Dr will give me and it isn’t helping much. I think of suicide, but I don’t want to do that to my family or my cat. I pray, count my blessings and endure.

  4. Florene

    Great site you’ve got here.. It’s difficult to find quality writing like yours
    nowadays. I seriously appreciate people like you!

    Take care!!

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