Advertisement

Schmerzstörung – Eine biopsychosoziale Erkrankung

Chapter
  • 2.3k Downloads

Zusammenfassung

Schmerz ist eine individuelle und ausschließlich subjektive Erfahrung. An der Verarbeitung von Schmerzreizen sind neben somatosensorischen Arealen auch emotionale Areale des zentralen Nervensystems wie z. B. das limbische System beteiligt. Schmerz ist keine rein sensorische Wahrnehmung, sondern hat immer auch emotionale Qualitäten. Schließlich spielt der familiäre und soziale Kontext des schmerzkranken Kindes eine wichtige Rolle bei der Schmerzempfindung. Für das Verständnis zur Entstehung und Aufrechterhaltung einer Schmerzstörung müssen sowohl biologische und psychologische Faktoren als auch der soziale Kontext berücksichtigt werden. In diesem Kapitel werden biologische, emotionale, kognitive und soziale Faktoren beschrieben, welche an der Entstehung, Aufrechterhaltung und Verstärkung einer Schmerzstörung beteiligt sind.

Literatur

  1. Asmundson GJ (2012) Do attentional biases for pain depend on threat value of pain and competing motivation toward non-pain goals? Pain [Epub ahead of print]Google Scholar
  2. Asmundson GJ, Norton PJ, Norton GR (1999) Beyond pain: the role of fear and avoidance in chronicity. Clin Psychol Rev 19(1): 97–119PubMedCrossRefGoogle Scholar
  3. Asmundson GJ, Coons MJ, Taylor S, Katz J (2002) PTSD and the experience of pain: research and clinical implications of shared vulnerability and mutual maintenance models. Can J Psychiatry 47(10): 930–937PubMedGoogle Scholar
  4. Baron R (2004) Mechanistic and clinical aspects of complex regional pain syndrome (CRPS). Novartis Found Symp 261: 220–233; discussion 233–238, 256–261PubMedCrossRefGoogle Scholar
  5. Bauer K, Hechler T, Dobe M, Hamann M, Vocks S, Zernikow B (2010) Kritische Lebensereignisse bei Jugendlichen mit chronischen Schmerzen: Auswirkungen auf den Schmerztherapie-Outcome? Schmerz 24 (Sonderheft Oktober 2010): 138–139Google Scholar
  6. Brune K, Beyer A, Schäfer F (2001) Schmerz – Pathophysiologie, Pharmakologie, Therapie. Heidelberg, New York, Tokio: SpringerGoogle Scholar
  7. Burba B, Oswald R, Grigaliunien V, Neverauskiene S, Jankuviene O, Chue P (2006) A controlled study of alexithymia in adolescent patients with persistent somatoform pain disorder. Can J Psychiatry 51(7): 468–471PubMedGoogle Scholar
  8. Chambers CT, Taddio A, Uman LS, McMurtry CM et al. (2009) Psychological interventions for reducing pain and distress during routine childhood immunizations: a systematic review. Clin Ther 31(2): 77–103CrossRefGoogle Scholar
  9. Coghill RC, McHaffie JG, Yen YF (2003) Neural correlates of interindividual differences in the subjective experience of pain. Proc Natl Acad Sci USA 100(14): 8538–8542PubMedCrossRefGoogle Scholar
  10. Crombez G, Bijttebier P, Eccleston C, Mascagni T, Mertens G, Goubert L et al. (2003) The child version of the pain catastrophizing scale (PCS-C): a preliminary validation. Pain 104(3): 639–646PubMedCrossRefGoogle Scholar
  11. Dobe M, Hechler T, Behlert J, Kosfelder J, Zernikow B (2011) Chronisch schmerzkranke, schwer beeinträchtigte Kinder und Jugendliche: Langzeiterfolge einer dreiwöchigen stationären Schmerztherapie Schmerz 25(4): 411–422Google Scholar
  12. Eccleston C, Malleson P (2003) Managing chronic pain in children and adolescents. We need to address the embarrassing lack of data for this common problem. BMJ 326(7404): 1408–1409PubMedCrossRefGoogle Scholar
  13. Eccleston C, Crombez G, Scotford A, Clinch J, Connell H (2004) Adolescent chronic pain: patterns and predictors of emotional distress in adolescents with chronic pain and their parents. Pain 108(3): 221–229PubMedCrossRefGoogle Scholar
  14. Essau CA (2007) Course and outcome of somatoform disorders in non-referred adolescents. Psychosomatics 48(6): 502–509PubMedCrossRefGoogle Scholar
  15. Feldman DS, Hedden DM, Wright JG (2000) The use of bone scan to investigate back pain in children and adolescents. J Pediatr Orthop 20(6): 790–795PubMedCrossRefGoogle Scholar
  16. Fernandez E, Boyle GJ (2002) Affective and evaluative descriptors of pain in the McGill Pain Questionnaire: reduction and reorganization. J Pain 3(1): 70–77PubMedGoogle Scholar
  17. Flor H, Diers M (2007) Limitations of pharmacotherapy: behavioral approaches to chronic pain. Handb Exp Pharmacol (177): 415–427Google Scholar
  18. Forgeron PA, McGrath P, Stevens B, Evans J, Dick B, Finley GA et al. (2011) Social information processing in adolescents with chronic pain: my friends don’t really understand me. Pain 152(12): 2773–2780PubMedCrossRefGoogle Scholar
  19. Geissner E (1995) Die Schmerzempfindungsskala SES – Ein differenziertes und veränderungssensitives Verfahren zur Erfassung akuter und chronischer Schmerzen. Rehabilitation 34(4): XXXV–XLIIIPubMedGoogle Scholar
  20. Goubert L, Craig KD, Vervoort T, Morley S, Sullivan MJ, de C Williams AC et al. (2005) Facing others in pain: the effects of empathy. Pain 118(3): 285–288PubMedCrossRefGoogle Scholar
  21. Goubert L, Eccleston C, Vervoort T, Jordan A, Crombez G (2006) Parental catastrophizing about their child’s pain. The parent version of the Pain Catastrophizing Scale (PCS-P): a preliminary validation. Pain 123(3): 254–263PubMedCrossRefGoogle Scholar
  22. Goubert L, Vervoort T, Sullivan MJ, Verhoeven K, Crombez G (2008) Parental emotional responses to their child’s pain: the role of dispositional empathy and catastrophizing about their child’s pain. J Pain 9(3): 272–279PubMedCrossRefGoogle Scholar
  23. Harden RN, Bruehl S, Stanton-Hicks M, Wilson PR (2007) Proposed new diagnostic criteria for complex regional pain syndrome. Pain Med 8(4): 326–331PubMedCrossRefGoogle Scholar
  24. Hechler T, Kosfelder J, Denecke H, Dobe M, Hübner B, Martin A, Menke A, Schroeder S, Marbach S, Zernikow B (2008) Schmerzbezogene Copingstrategien von Kindern und Jugendlichen mit chronischen Schmerzen – Überprüfung einer deutschen Fassung der Paediatric Pain Coping Inventory (PPCI). Schmerz 22(4): 442–457PubMedCrossRefGoogle Scholar
  25. Hechler T, Kosfelder J, Vocks S, Mönninger T, Blankenburg M, Dobe M et al. (2010) Changes in pain-related coping strategies and their importance for treatment outcome following multimodal inpatient treatment: does sex matter? J Pain 11(5): 472–483PubMedCrossRefGoogle Scholar
  26. Hermann C, Hohmeister J, Zohsel K, Ebinger F, Flor H (2007) The assessment of pain coping and pain-related cognitions in children and adolescents: current methods and further development. J Pain 8(10): 802–813PubMedCrossRefGoogle Scholar
  27. IASP Task Force on Taxonomy, Merskey H, Bogduk N (1994) Classification of chronic pain, part III. Pain terms, a current list with definitions and notes on usage, 2. Aufl. IASP Press, SeattleGoogle Scholar
  28. Jordan AL, Eccleston C, Osborn M (2007) Being a parent of the adolescent with complex chronic pain: an interpretative phenomenological analysis. Eur J Pain 11(1): 49–56PubMedCrossRefGoogle Scholar
  29. Keogh E, Eccleston C (2006) Sex differences in adolescent chronic pain and pain-related coping. Pain 123(3): 275–284PubMedCrossRefGoogle Scholar
  30. LeResche L, Mancl LA, Drangsholt MT, Saunders K, Korff MV (2005) Relationship of pain and symptoms to pubertal development in adolescents. Pain 118(1–2): 201–209PubMedCrossRefGoogle Scholar
  31. Logan DE, Catanese SP, Coakley RM, Scharff L (2007) Chronic pain in the classroom: teachers’ attributions about the causes of chronic pain. J Sch Health 77(5): 248–256PubMedCrossRefGoogle Scholar
  32. Maciver D, Jones D, Nicol M (2010) Parents’ experiences of caring for a child with chronic pain. Qual Health Res 20(9): 1272–1282PubMedCrossRefGoogle Scholar
  33. Manschwetus H (2003) Qualitätsstandards und Zertifizierungen der Patientenschulung in der Rheumatologie. Z Rheumatol 62(2): 21–23Google Scholar
  34. McCracken LM, MacKichan F, Eccleston C (2007) Contextual cognitive-behavioral therapy for severely disabled chronic pain sufferers: effectiveness and clinically significant change. Eur J Pain 11(3): 314–322PubMedCrossRefGoogle Scholar
  35. Melzack R (2005) Evolution of the neuromatrix theory of pain. The Prithvi Raj Lecture: presented at the third World Congress of World Institute of Pain, Barcelona 2004. Pain Pract 5(2): 85–94PubMedCrossRefGoogle Scholar
  36. Melzack R, Wall PD (1965) Pain mechanisms: a new theory. Science 150(3699): 971–979PubMedCrossRefGoogle Scholar
  37. Merlijn VP, Hunfeld JA, van der Wouden JC, Hazebroek-Kampschreur AA, Koes BW, Passchier J (2003) Psychosocial factors associated with chronic pain in adolescents. Pain 101(1–2): 33–43PubMedCrossRefGoogle Scholar
  38. Nagel B, Gerbershagen HU, Lindena G, Pfingsten M (2002) Entwicklung und empirische Überprüfung des Deutschen Schmerzfragebogens der DGSS. Schmerz 16(4): 263–270PubMedCrossRefGoogle Scholar
  39. Nakao M, Barsky AJ (2007) Clinical application of somatosensory amplification in psychosomatic medicine. Biopsychosoc Med 9: 1–17CrossRefGoogle Scholar
  40. Palermo TM, Chambers CT (2005) Parent and family factors in pediatric chronic pain and disability: an integrative approach. Pain 119(1–3): 1–4PubMedCrossRefGoogle Scholar
  41. Reid GJ, Gilbert CA, McGrath PJ (1998) The Pain Coping Questionnaire: preliminary validation. Pain 76(1–2): 83–96PubMedCrossRefGoogle Scholar
  42. Rief W, Barsky AJ (2005) Psychobiological perspectives on somatoform disorders. Psychoneuroendocrinology 30(10): 996–1002PubMedCrossRefGoogle Scholar
  43. Schroeder S, Hechler T, Denecke H, Müller-Busch M, Martin A, Menke A, Zernikow B (2010) Deutscher Schmerzfragebogen für Kinder, Jugendliche und deren Eltern (DSF-KJ) – Ein multimodaler Fragebogen zur Diagnostik und Therapie chronischer Schmerzen im Kindes- und Jugendalter. Schmerz 24(1): 23–37PubMedCrossRefGoogle Scholar
  44. Turk DC, Okifuji A (1999) Assessment of patients’ reporting of pain: an integrated perspective. Lancet 353(9166):1784–1788PubMedCrossRefGoogle Scholar
  45. Vervoort T, Huguet A, Verhoeven K, Goubert L (2011) Mothers’ and fathers’ responses to their child’s pain moderate the relationship between the child’s pain catastrophizing and disability. Pain 152(4): 786–793PubMedCrossRefGoogle Scholar
  46. Vlaeyen JW, Linton SJ (2000) Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 85(3): 317–332PubMedCrossRefGoogle Scholar
  47. Walker LS, Smith CA, Garber J, Claar RL (2007) Appraisal and coping with daily stressors by pediatric patients with chronic abdominal pain. J Pediatr Psychol 32(2): 206–216PubMedCrossRefGoogle Scholar
  48. Wicksell RK, Melin L, Olsson GL (2007) Exposure and acceptance in the rehabilitation of adolescents with idiopathic chronic pain – a pilot study. Eur J Pain 11(3): 267–274PubMedCrossRefGoogle Scholar
  49. Wicksell RK, Melin L, Lekander M, Olsson GL (2009) Evaluating the effectiveness of exposure and acceptance strategies to improve functioning and quality of life in longstanding pediatric pain – a randomized controlled trial. Pain 141(3): 248–257PubMedCrossRefGoogle Scholar
  50. Zernikow B (2009) Schmerztherapie bei Kindern, Jugendlichen und jungen Erwachsenen, 4. Aufl. Springer, HeidelbergCrossRefGoogle Scholar
  51. Zernikow B, Wager J, Hechler T, Hasan C, Rohr U, Dobe M et al. (2012) Characteristics of highly impaired children with severe chronic pain: a 5-year retrospective study on 2.249 pediatric pain patients. BMC Pediatr 12(1): 54PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Deutsches Kinderschmerzzentrum, Vestische Kinder- u. JugendklinikUniversität Witten/HerdeckeDattelnDeutschland

Personalised recommendations