Cognitive Processing and Self-Pain Enmeshment in Chronic Back Pain

Adina C. Rusu and Tamar Pincus

Introduction

Given the detrimental effect of chronic pain on the individual and his or her surrounding environment, research into the factors and mechanisms that contribute to the aetiology, persistence, and effective management of chronic pain has increased significantly in the last decades (Morley et al. 1999; McCracken and Turk 2002; Turk and Okifuji 2002). This growing research interest has (amongst other outcomes) resulted in the identification of a number of psychological factors and mechanisms that may predispose persons toward, or conversely protect them against the development of persistent pain. This chapter contributes to this line of research by focusing on the specific contribution of some of these proposed vulnerability factors. The present chapter focuses on cognitive mechanisms and processes occurring at strategic and automatic levels that constitute a mediating or moderating role in pain and pain-related disability. Before introducing the precise research questions that have been explored in this context, in the following paragraphs a brief overview of cognitive processing theories will be provided. The main part of this chapter will focus on the theoretical background against which the current research was conducted. Furthermore, empirical evidence on cognitive processing biases in chronic pain will be reviewed. Finally, this chapter will end with perspectives on the main clinical implications of this line of research and future research directions.