Toward an Integrative Diathesis-Stress Model of Chronic Pain

  • Robert D. Kerns
  • Mary Casey Jacob
Part of the Springer Series in Rehabilitation and Health book series (SSRH)


The devastating problem of chronic pain exemplifies the need for innovation in conceptualizing health problems and the importance of developing alternative health-care delivery systems. First, there is probably no greater source of stress and human suffering than the experience of pain. Researchers have estimated that one third of Americans suffer from persistent and recurrent pain (Bonica, 1981) with 35 million people suffering from low back pain alone (Bonica, 1980). In a survey of subscribers to a large community health maintenance organization, Von Korff, Dworkin, LeResche, and Kruger (1988) reported that 41% had suffered low back pain in the last 6 months. In the same sample, 26% had recurrent headaches, 18% reported abdominal pain, 12% had chest pain, and 12% had facial pain. The economic costs of chronic pain are equally staggering due to both direct health-care costs, including the purchase of prescribed and over-the-counter medications, and the indirect financial burden of underemployment, lost productivity, and disability compensation. As one example, Stone (1984) estimated the lifetime economic costs of rheumatoid arthritis to exceed $20,000 per patient in 1977 dollars!


Chronic Pain Pain Experience Marital Satisfaction Pain Behavior Chronic Pain Patient 
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Copyright information

© Springer Science+Business Media New York 1995

Authors and Affiliations

  • Robert D. Kerns
    • 1
  • Mary Casey Jacob
    • 2
  1. 1.Psychology Service, West Haven Veterans Administration Medical Center, and Departments of Psychiatry, Neurology, and PsychologyYale UniversityWest HavenUSA
  2. 2.Departments of Psychiatry (Psychology), and Obstetrics and GynecologyUniversity of Connecticut Health CenterFarmingtonUSA

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