[...]... predicted level of functioning, pain severity, pain- related disability, less use of active coping, and more use of passive coping in patients in a university chronic pain inpatient unit [Fisher et al., 2001] The consequences of depression can be extreme Patients suffering from chronic pain syndromes including migraine, chronic abdominal pain, and orthopedic pain syndromes report increased rates of suicidal... suicide in chronic pain Clin J Pain 1991;7: 29–36 Perspectives on Pain and Depression 21 Fishbain DA, Rosomoff HL, Cutler RB, et al: Do chronic pain patients’ perceptions about their preinjury jobs determine their intent to return to the same type of job post -pain facility treatment Clin J Pain 1995;11:267–278 Fishbain DA, Rosomoff HL, Rosomoff RS: Drug abuse, dependence: Addiction in chronic pain patients... Psychological interventions for chronic pain: A critical review I Relaxation training and biofeedback Pain 1982;12:1–21 Turner JA, Jensen MP, Romano JM: Do beliefs, coping, and catastrophizing independently predict functioning in patients with chronic pain? Pain 2000;85:115–125 Turner JA, Jensen MP, Warms CA, et al: Catastrophizing is associated with pain intensity, psychological distress, and pain- related... abilities to control and reduce pain [Hallberg and Carlsson, 1998] Catastrophic thinking about pain has been attributed to the amplification of threatening information and it interferes with the focus needed to facilitate patients remaining involved with productive instead of pain- related activities [Crombez et al., 1998] Catastrophizing intensifies the experience of pain and increases emotional distress... 2000;22:794–801 Arnstein P, Caudill M, Mandle CL, et al: Self efficacy as a mediator of the relationship between pain intensity, disability and depression in chronic pain patients Pain 1999;80:483–491 Asghari A, Nicholas MK: Pain self-efficacy beliefs and pain behaviour A prospective study Pain 2001;94:85–100 Asmundson GJG, Norton PJ, Norton GR: Beyond pain: The role of fear and avoidance in chronicity Clin Psychol... Perspectives on Pain and Depression 25 Taub A: Opioid analgesics in the treatment of chronic intractable pain on non-neoplastic origin; in Kitahata LM (ed): Narcotic Analgesics in Anesthesiology Baltimore, Williams & Wilkins, 1982, pp 199–208 Turk DC, Matyas TA: Pain- related behaviors: Communication of pain Am Pain Soc J 1992;1:109–111 Turk DC, Meichenbaum D, Genest M: Pain and Behavioral Medicine: A Cognitive-Behavioral... Higher levels of disability were found in persons who remain passive or use coping strategies of catastrophizing, ignoring or reinterpreting pain sensations, diverting attention from pain, and praying or hoping for relief In a 6-month follow-up study of patients completing an inpatient pain program, improvement was associated with decreases in the use of passive coping strategies [Jensen et al., 1994]... Weiner DK, et al: Pain in older adults: A cognitive-behavioral perspecitive; in Ferrell BR, Ferrell BA (eds): Pain in the Elderly Seattle, IASP Press, 1996, pp 11–19 Keefe FJ, Caldwell DS, Williams DA, et al: Pain coping skills training in the management of osteoarthritic knee pain: A comparative study Behav Ther 1990a;21:49–62 Keefe FJ, Caldwell DS, Williams DA, et al: Pain coping skills training in. .. disability [Li and Moore, 1998] Therefore, acceptance is a realistic approach to living with pain that incorporates both the disengagement from struggling against pain and engagement in productive everyday activities with achievable goals Achieving acceptance of pain is associated with reports of lower pain intensity, less pain- related anxiety and avoidance, less depression, less physical and psychosocial... disability that individuals experience by modifying their response to pain An example is a patient presenting with suicidal feelings in the context of chronic pain, disability, and benzodiazepine abuse The patient was injured when a bus she was riding collided with another vehicle resulting in a facial injury She was mildly disfigured and had chronic jaw pain exacerbated by chewing and talking The patient . Patients suffering from chronic pain syndromes including migraine, chronic abdominal pain, and orthopedic pain syndromes report increased rates of suicidal. on Pain and Depression 3 evaluation should assess initiating, sustaining, and comorbid factors contributing to their condition [Clark, 2000; Clark and