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Verhaltensmedizinische Grundlagen chronischer Schmerzen

Zusammenfassung

Lange Zeit wurden chronische Schmerzsyndrome wie auch andere chronische Erkrankungen nur im Rahmen des medizinischen Modells und damit als rein organmedizinische Erkrankungen gesehen. Da aber bei vielen Schmerzsyndromen keine organische Pathologie vorfindbar ist und auch die darauf zielenden Therapieverfahren sich als wenig effizient erwiesen haben (Spangfort 1988), hat eine interdisziplinäre Perspektive zunehmend Beachtung gefunden. Engel forderte 1977 generell die Ablösung des medizinischen Modells durch eine biopsychosoziale Perspektive. Ein multifaktorieller Ansatz ist gerade bei chronischen Krankheiten wichtig, da im Verlauf der Erkrankung oft die ursprünglich krankheitsauslösenden Faktoren mehr und mehr in den Hintergrund treten und der Umgang mit der Erkrankung immer wichtiger wird (Holroyd u. Creer 1986). Diese Krankheitsbewältigung ist von Lernprozessen beeinflußt (Fordyce 1976, 1986; Turk et al. 1983). Somit wird der verhaltensmedizinische Ansatz zunehmend wichtig, der ein multifaktorielles Modell von Krankheit und Gesundheit vertritt. Es geht der Verhaltensmedizin um die Integration biomedizinischer und sozialwissenschaftlicher Theorien und Methoden bei der Erforschung wie auch Behandlung von Erkrankungen (Schwartz u. Weiss 1978a, 1978b). Dabei spielen behaviorale Ansätze eine besondere Rolle (Pomerleau u. Brady 1979).

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  • H. Flor

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