LEADER 11591nam 2200733Ia 450 001 9910819272403321 005 20200520144314.0 010 $a1-280-22149-6 010 $a9786610221493 010 $a0-309-54267-7 010 $a0-585-14910-0 035 $a(CKB)110986584750784 035 $a(OCoLC)427404677 035 $a(CaPaEBR)ebrary10062844 035 $a(SSID)ssj0000217481 035 $a(PQKBManifestationID)11190072 035 $a(PQKBTitleCode)TC0000217481 035 $a(PQKBWorkID)10213258 035 $a(PQKB)11484247 035 $a(MiAaPQ)EBC3376961 035 $a(Au-PeEL)EBL3376961 035 $a(CaPaEBR)ebr10062844 035 $a(OCoLC)814282643 035 $a(EXLCZ)99110986584750784 100 $a19870416d1987 uy 0 101 0 $aeng 135 $aurcn||||||||| 181 $ctxt$2rdacontent 182 $cc$2rdamedia 183 $acr$2rdacarrier 200 00$aPain and disability $eclinical, behavioral, and public policy perspectives /$fInstitute of Medicine, Committee on Pain, Disability, and Chronic Illness Behavior ; Marian Osterweis, Arthur Kleinman, and David Mechanic, editors 205 $a1st ed. 210 $aWashington, D.C. $cNational Academy Press$d1987 215 $a1 online resource (ix, 306 pages) 300 $aBibliographic Level Mode of Issuance: Monograph 311 0 $a0-309-07458-4 311 0 $a0-309-03737-9 320 $aIncludes bibliographies and index. 327 $aPain and Disability -- Copyright -- PREFACE AND ACKNOWLEDGMENTS -- Contents -- SUMMARY -- CHRONIC PAIN -- SOCIAL SECURITY ADMINISTRATION DISABILITY PROGRAMS -- Problems in the System -- CRITICAL GAPS IN KNOWLEDGE -- RECOMMENDATIONS -- 1 Introduction -- Overview of the Report -- A Note about Definitions -- References -- PART I THE PROBLEM OF PAIN FOR THE SOCIAL SECURITY ADMINISTRATION -- 2 The Sociopolitical Background of the Pain Issue -- THE LEGISLATIVE BACKGROUND OF THE PAIN PROBLEM IN DISABILITY INSURANCE -- Early History of Social Security Disability -- Physicians' Concerns About Medically Determined Disability -- The Concept of Impairment -- Disability and the Labor Market -- The 1984 Amendments -- DISABILITY, PAIN, AND DISTRIBUTIVE JUSTICE -- References -- 3 Disability Determination and the Role Of Pain -- OVERVIEW OF THE SOCIAL SECURITY DISABILITY SYSTEM -- The Programs -- Program Definitions -- The Application and Evaluation Process -- The Appeals Process -- Program Benefits -- Incentives for Rehabilitation and Return to Work -- PAIN'S ROLE IN THE DETERMINATION OF DISABILITY -- Pain in Social Security Law and Regulation -- Pain and the Application Process -- Pain and the Sequential Evaluation Process -- Pain and the Courts -- COMPARISON WITH OTHER DISABILITY COMPENSATION PROGRAMS -- Veterans Administration -- The Role of Pain -- Workers' Compensation -- The Role of Pain -- Private Disability Insurance -- The Role of Pain -- Disability Compensation Programs in Western Europe -- References -- 4 Conflicts And Contradictions In The Disability Program -- CONGRESS AND THE SOCIAL SECURITY ADMINISTRATION -- TENSIONS WITHIN THE PROGRAM -- Medical Definitions Versus Functional Concept -- Income Support Versus Rehabilitation -- Physicians, Claimants, and Administrators -- Administrative Law Judges Versus Program Administrators. 327 $aTHE FEDERAL COURTS AND CHRONIC DISABLING PAIN -- COMPENSATION AND INCENTIVES -- Importance of Job Satisfaction -- Program Rules as an Explanation of Labor Supply -- Employment Opportunity as a Determinant of Labor Supply -- CONCLUSIONS -- References -- PART II THE EXTENT AND COST OF THE PROBLEM -- 5 Economic Issues and the Cost of Disability -- DISABILITY EXPENDITURES -- Cash Transfers -- Medical Care -- Direct Services -- TRENDS IN EXPENDITURES -- Disabled Persons -- A Note About Measurement -- Number and Characteristics of the Disabled -- Benefit Levels and Beneficiaries -- Program Influences -- Program Efficiency -- PREVENTING DISABILITY BY REALLOCATING FUNDS -- THE ECONOMICS OF PAIN: GAPS IN THE LITERATURE -- CONCLUSIONS -- References -- 6 The Epidemiology of Chronic Pain and Work Disability -- METHODOLOGICAL ISSUES -- Definitions and Measures of Chronic Pain -- Study Samples -- Methods of Data Collection -- PAIN AND ITS CONSEQUENCES -- What Kinds of Chronic Pain Do People Have? -- Incidence and Prevalence of Relevant Outcomes -- Back Pain and Medical Care -- Descriptive Epidemiology of Chronic Pain and Disability -- Trends in Time -- Demographic Factors, Pain, and Work Disability -- Physical Factors -- Socioeconomic Status -- Psychosocial Factors -- Research Agenda -- Epidemiological Studies -- Methodological Research -- References -- PART III INFLUENCES ON PAIN AND PAIN BEHAVIOR -- 7 The Anatomy and Physiology of Pain -- PAIN PROCESSES -- Transduction -- Transmission -- Peripheral Nervous System -- Pain Pathways In the Central Nervous System -- Sensory Versus Affective Aspects of Pain -- Modulation -- PHYSIOLOGICAL PROCESSES THAT ENHANCE PAIN AND MAY LEAD TO CHRONICITY -- Sensitization -- Hyperactivity of the Sympathetic Nervous System: Reflex Sympathetic Dystrophy -- Muscle Contraction. 327 $aSelf-Sustaining Painful Processes: Livingston's ''Vicious Circle'' -- Neuropathic Pain -- Acute Versus Chronic Pain -- POTENTIAL METHODS OF PHYSIOLOGICAL MONITORING -- References -- 8 Illness Behavior and the Experience of Pain -- ILLNESS BEHAVIOR: AN INTEGRATING CONCEPT -- THE PROCESS OF ILLNESS BEHAVIOR -- Symptom Perception -- Meaning Attribution -- Expression and Communication -- Help-Seeking Behavior and Other Coping Responses -- THE INFLUENCE OF PERSONALITY, FAMILIAL, AND SOCIOCULTURAL FACTORS ON ILLNESS BEHAVIOR -- Personality and Illness Behavior -- Family Influences -- Cultural Influences -- CONCLUSIONS -- References -- 9 Psychiatric Aspects of Chronic Pain -- EPIDEMIOLOGY OF CERTAIN PSYCHIATRIC DISORDERS -- CHRONIC PAIN, DEPRESSION, AND ANXIETY -- Chronic Pain, Depression, and Somatoform Disorders -- A Neurobiological View of Chronic Pain and Depression -- Depression as a Consequence of Chronic Pain -- Depressive Symptoms as a Consequence of Drug Therapy -- TREATMENT OF DEPRESSIVE DISORDERS IN THE CHRONIC PAIN PATIENT -- Psychotherapeutic Treatment -- Psychopharmacological Treatment of Pain -- ADDICTION AND ALCOHOLISM -- PERSONALITY FACTORS AND CHRONIC PAIN -- RESEARCH ON PSYCHIATRIC ASPECTS OF CHRONIC PAIN -- References -- PART IV ASSESSING AND TREATING PAIN AND DYSFUNCTION -- 10 Chronic Pain in Medical Practice -- CLINICAL DECISION MAKING -- The Diagnostic Process -- Treatment of the Pain and the Disorder: The Medical Model -- DIAGNOSING AND MANAGING THE PATIENT WITH PAIN: AN EXPANDED MODEL -- WHY IS THE DIAGNOSIS OF CHRONIC PAIN SO ELUSIVE? -- Unknown Disease Processes -- Overlooked Diagnoses -- Controversial Diagnoses -- Myofascial Trigger Point Syndromes -- Fibrositis or Fibromyalgia -- Articular Dysfunction -- IMPROVING DIAGNOSIS, TREATMENT, AND PREVENTION -- Diagnosis -- Treatment Of Chronic Pain -- Bed Rest And Restricted Activity. 327 $aDrug Therapy -- Surgical Treatment -- RECOMMENDATIONS FOR CLINICAL RESEARCH -- References -- 11 Measuring Pain And Dysfunction -- BASIC CONCEPTS OF MEASUREMENT -- MEASUREMENT TOOLS -- Measurement Of Subjective Pain States -- Self-Report: Data From Introspection -- Self-Report Methods Using A Single Dimension -- Self-Report Of Pain In Several Dimensions -- Pain As Behavior: Observational Data -- Pain Judgments By Health Care Providers -- Measurement Of Pain Behavior -- Mixed Methods: Self-Reports Of Pain Behaviors -- RELATED MEASURES OF DISABILITY -- Pain And Functional Status -- Disability Assessment -- Sickness Impact -- Assessment of Work Performance -- Severity of Pain and Dysfunction -- FACTORS BIASING PAIN MEASUREMENT -- Personal Meaning -- Coping -- Memory for Pain -- Attributional Factors -- Medication Toxicity -- SUMMARY -- IMPLICATIONS FOR SSA DISABILITY ASSESSMENT -- MEASUREMENT PANELISTS -- References -- 12 Rehabilitation Approaches And Issues In Chronic Pain -- THE REHABILITATION APPROACH -- PAIN MANAGEMENT PROGRAMS: AN OVERVIEW -- The Need for Standards -- REHABILITATION TECHNIQUES FOR PATIENTS WITH CHRONIC PAIN -- Physical Modalities -- Behavior Modification -- Patient Education -- Psychosocial Rehabilitation -- Stress Management -- Medical Interventions for Pain Control -- Attention to Myofascial Trigger Points -- Use of Drugs -- Nerve Blocks and Epidural Steroid Injections -- Vocational Rehabilitation -- OUTCOMES OF PAIN MANAGEMENT PROGRAMS -- EMPLOYMENT AND COMPENSATION AS INCENTIVES OR DISINCENTIVES IN OUTCOMES OF PAIN MANAGEMENT PROGRAMS -- Employment as A Factor in Treatment Outcome -- Compensation Status as A Factor in Treatment Outcome -- Studies Suggesting a Negative Effect of Compensation on Outcome -- Studies Suggesting Little or No Negative Effect of Compensation -- REHABILITATION ISSUES IMPORTANT TO THE SSA. 327 $aThe Ssa and Vocational Rehabilitation -- Measurement and Evaluation of Pain -- The Question of Mandatory Rehabilitation -- Research and Demonstration Projects -- References -- PART V CONCLUSIONS AND RECOMMENDATIONS -- 13 Conclusions and Recommendations -- RECOMMENDATION 1 DATA COLLECTION AT THE SSA -- RECOMMENDATION 2 NO NEW LISTINGS FOR PAIN OR ILLNESS BEHAVIOR -- RECOMMENDATION 3 SIGNIFICANT PAIN' SHOULD TRIGGER AN ASSESSMENT -- RECOMMENDATION 4 DEMONSTRATION PROJECTS -- Demonstration: The Feasibility and Consequences of Early Assessment -- Simple Assessment Tool -- Early Face-to-Face Hearing -- Integrated Functional Assessment -- Demonstration Project: Does Early Rehabilitation Work? -- Incentives and Disincentives for Rehabilitation -- The HHS Pain Commission's Proposal -- Demonstration Project for Early Rehabilitation -- Evaluation of the Demonstrations -- A Note About Research with Human Subjects -- RECOMMENDATION 5 RESEARCH AGENDA -- Epidemiological Initiatives -- Clinical Research -- Health Services Research -- Improved Methodology and Multidisciplinary Research -- RECOMMENDATION 6 EDUCATION TO IMPROVE THE CLINICAL CARE AND TREATMENT OF CHRONIC PAIN PATIENTS -- APPENDIX -- MYOFASCIAL PAIN SYNDROMES DUE TO TRIGGER POINTS -- MYOFASCIAL PAIN SYNDROMES: HOW COMMON ARE THEY? -- Why Are Myofascial Pain Syndromes So Common? -- HISTORICAL BACKGROUND -- NATURAL HISTORY -- DIAGNOSIS -- PERPETUATING FACTORS -- TREATMENT -- REFERENCES -- INDEX. 330 $aEvaluating claims based on pain poses problems for the Social Security Administration (SSA) and other disability insurers. This volume covers the epidemiology and physiology of pain; psychosocial contributions to pain and illness behavior; promising ways of assessing and measuring chronic pain and dysfunction; and clinical aspects of prevention. 606 $aChronic pain$xSocial aspects 606 $aChronic pain$xGovernment policy 606 $aChronic pain$xEconomic aspects 606 $aDisability evaluation 615 0$aChronic pain$xSocial aspects. 615 0$aChronic pain$xGovernment policy. 615 0$aChronic pain$xEconomic aspects. 615 0$aDisability evaluation. 676 $a362.1 701 $aOsterweis$b Marian$01640666 701 $aKleinman$b Arthur$01603249 701 $aMechanic$b David$f1936-$0882400 712 02$aInstitute of Medicine (U.S.).$bCommittee on Pain, Disability, and Chronic Illness Behavior. 801 0$bMiAaPQ 801 1$bMiAaPQ 801 2$bMiAaPQ 906 $aBOOK 912 $a9910819272403321 996 $aPain and disability$94077316 997 $aUNINA