Schmerzurteil und Kontext - Beiträge zur Klassifikation generalisierter Schmerzen (English shop)

Preview

Table of Contents, Datei (41 KB)
Extract, Datei (47 KB)

Ralf Dohrenbusch’s habilitation thesis examines the diagnostic classification of generalized rheumatic pain and the influence of situational and psychosocial contextual factors on individual pain perception and assessment. The research focuses on whether established classification criteria, particularly those developed by the American College of Rheumatology for fibromyalgia, provide a reliable basis for distinguishing different groups of chronic pain patients. The investigation begins with a critical examination of the epidemiological, methodological, and diagnostic foundations of fibromyalgia classification. Particular attention is given to the extent to which pain reports depend on examination conditions, patient sample selection, and individual illness behavior. To investigate these relationships systematically, the study develops the Pressure Pain Profile, a standardized assessment procedure incorporating 19 variables describing clinical pain characteristics and context-dependent responses to experimentally induced pain. The method combines pressure pain measurements, structured interviews, questionnaires, and behavioral observations and is evaluated and standardized using a sample of 121 fibromyalgia patients. Another major research area compares patients with fibromyalgia and rheumatoid arthritis to identify differences in clinical pain symptoms and experimentally measured pain sensitivity. The findings demonstrate that context-related variables can contribute substantially to differentiating the investigated patient groups. Additional empirical studies examine associations between pain judgments, psychosocial adjustment, and pain-related control beliefs. Particular emphasis is placed on sensitization, interference, and equivalence effects as determinants of responses to experimental pain stimulation. The research further investigates differences between fibromyalgia patients with and without a desire for disability pension benefits and their relationship to experimental pain assessment. The results indicate that contextual variables can predict important determinants of illness behavior and healthcare-seeking behavior more effectively than conventional clinical pain characteristics in several investigated comparisons. Based on these findings, the dissertation proposes extending existing diagnostic classification systems by incorporating context-dependent measures to account for situational influences and potential patient selection effects. The study contributes to psychological pain assessment and provides a methodological foundation for improving the classification and differentiation of generalized pain conditions.