Internal Image of Disorder in Patients with Chronic Back Pain

201

Abstract

The purpose of the work was to study the psychological mechanisms of the formation of an intrapsychic response to chronic back pain. The hypothesis was the assumption that the internal image of the disorder in patients with chronic back pain differs depending on the subjective perception of pain. Operationalization of the internal image of disorder was carried out in accordance with a four-level concept (sensitive, motivational, emotional, and intellectual levels). Psychodiagnostic tools were used: "McGill's Pain Questionnaire (Kastiro I.V., 2012), "Restoration of the locus of control" questionnaire (Belova N.A., 2002), expert assessment of compliance on a five-point scale, "Psychological factors of attitude to illness and treatment" questionnaire (Rasskazova E.I., 2016). In total, 84 patients aged 54.5±14.4 years were examined, including 52 (61.9%) women and 32 (38.1%) men who were at the inpatient stage of medical rehabilitation for dorsopathies with moderate chronic pain syndrome. The pain has lasted for 12.9±13.4 years. As a result of the study, it was found that the groups of patients with mixed and nociceptive pain differ from each other in the structure of the internal image of the disorder: patients with mixed pain have no relationship between the motivational and emotional levels with the sensitive – the level of primary processing of sensory information.

General Information

Keywords: internal image of the disorder, chronic pain, nociceptive pain, neuropathic pain, mixed pain, dorsopathy

Journal rubric: Empirical Research

Article type: scientific article

DOI: https://doi.org/10.17759/cpse.2022110406

Acknowledgements. The authors express their gratitude to the staff of the branch no. 3 of the Moscow Scientific and Practical Centre of Medical Rehabilitation, Regenerative and Sports Medicine of Moscow City Healthcare Department for their assistance in organizing the study.

Received: 31.01.2022

Accepted:

For citation: Kotelnikova A.V., Kukshina A.A., Tihonova A.S., Buzina T.S. Internal Image of Disorder in Patients with Chronic Back Pain [Elektronnyi resurs]. Klinicheskaia i spetsial'naia psikhologiia = Clinical Psychology and Special Education, 2022. Vol. 11, no. 4, pp. 138–158. DOI: 10.17759/cpse.2022110406. (In Russ., аbstr. in Engl.)

References

  1. Bolevye sindromy v nevrologicheskoi praktike [Pain syndromes in neurological practice]. A.M. Vein (ed.). Moscow: MEDpress-inform, 2001. 368 p. (In Russ.).
  2. Burlachuk L.F., Morozov S.M. Slovar'-spravochnik po psikhodiagnostike [Dictionary-reference book on psychodiagnostics]. Saint Petersburg: Piter, 2001. 528 p. (In Russ.).
  3. Danilov A.B., Danilov Al.B. Upravlenie bol'yu. Biopsikhosotsial'nyi podkhod [Pain management. Biopsychosocial approach]. Moscow: «AMM PRESS», 2016. 636 p. (In Russ.).
  4. Zamyatin A.V. Vvedenie v intellektual'nyi analiz dannykh: uchebnoe posobie [Introduction to Data Mining: A Study Guide]. Tomsk: Izdatel'skii Dom Tomskogo gosudarstvennogo universiteta, 2016. 118 p. URL: http://vital.lib.tsu.ru/vital/access/manager/Repository/vtls:000529594 (Accessed: 09.12.2022). (In Russ.).
  5. Zinovieva O.E., Barinov A.N. Patogeneticheskoe lechenie nespetsificheskoi boli v spine [Pathogenetic treatment of non-specific back pain]. Meditsinskii sovet = Medical Council, 2018, no. 9, pp. 25–28. DOI: 10.21518/2079-701X-2018-9-25-28 (In Russ, abstr. in Engl.).
  6. Izbrannye lektsii po meditsinskoi reabilitatsii [Selected lectures on medical rehabilitation]. A.N. Razumov, E.A. Turova, V.I. Koryshev et al. (eds.). Tambov: «Izdatel'stvo Yulis», 2016. 278 p. (In Russ.).
  7. Isaikin A.I., Kuznetsov I.V., Kavelina A.V. et al. Nespetsificheskaya lyumbalgiya: prichiny, klinika, diagnostika, lechenie [Nonspecific low back pain: Causes, clinical picture, diagnosis, and treatment]. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics, 2015, vol. 7, no. 4, pp. 101–109. DOI: 10.14412/2074-2711-2015-4-101-109 (In Russ, abstr. in Engl.)
  8. Ishinova V.A. , Mityakova O.N., Povorinskiy A.A. Znachenie khronicheskoi boli v formirovanii «Vnutrennei kartiny boleznI» u bol'nykh, perenesshikh amputatsiyu nizhnikh konechnostei i revaskulyarizatsiyu miokarda, do i posle kursa ehmpatotekhniki [The role of chronic pain in the formation of «internal picture of the disease» in patients after lower-limb amputation and myocardial revascularization before and after a course of empatho-technique]. Mediko-Sotsyal'naya Ekspretiza i Reabilitatsiya = Medical and Social Expert Evaluation and Rehabilitation, 2015, no. 3, pp. 15–21. (In Russ, abstr. in Engl.).
  9. Kastyro I.V., Popadyuk V.I., Blagonravov M.L. et al. Oprosnik boli Mak-Gilla kak metod opredeleniya urovnya bolevogo sindroma u patsientov posle rinoseptoplastiki i polipotomii nosa [McGill Pain Questionnaire as a method of identification of pain syndrome level in patients after rhynoseptoplasty and polypothomy]. Byulleten' Vostochno-Sibirskogo nauchnogo tsentra Sibirskogo otdeleniya Rossiiskoi akademii nauk = Acta Biomedica Scientifica (East Siberian Biomedical Journal), 2012, vol. 86, no. 4, part 2, pp. 68–71. (In Russ, abstr. in Engl.)
  10. Kotelnikova A.V., Kukshina A.A., Tihonova A.S. et al. Priverzhennost' k lecheniyu kak prediktor ehffektivnosti vklyucheniya tekhnologii VR i AR v psikhologicheskoe soprovozhdenie patsientov s narusheniem dvigatel'nykh funktsii v protsesse meditsinskoi reabilitatsii [Adherence to treatment as a predictor of the effectiveness of including VR and AR technologies in the psychological support of patients with movement disorders in medical rehabilitation]. Kremlevskaya meditsina. Klinicheskii vestnik = Kremlin Medicine Journal, 2020, no. 3, pp. 72-81. DOI: 10.26269/72cj-dh29 (In Russ, abstr. in Engl.)
  11. Kuzminova T.I., Mukhametzyanova A.K., Magomedkerimova L.V. Psikhologicheskie metody lecheniya khronicheskoi nespetsificheskoi boli v spine [Psychological Methods of Chronic Non-Specific Pain Treatment]. Rossiiskii nevrologicheskii zhurnal = Russian Neurological Journal, 2020, vol. 25, no. 2, pp. 12–21. DOI: 10.30629/2658-7947-2020-25-2-12-21. (In Russ. abstr. in Engl.)
  12. Migunova Yu.M. Psikhologicheskie faktory khronifikatsii pri golovnoi boli [Psychological factors of illness perpetuation in patients with headaches]. Psikhologicheskie issledovaniya = Psychological Studies, 2018, vol. 11, no. 57, pp. 12. URL: https://psystudy.ru/index.php/num/article/view/325/601 (Accessed: 09.12.2022). (In Russ. abstr. in Engl.)
  13. Nasledov A.D. Matematicheskie metody psikhologicheskogo issledovaniya. Analiz i interpretatsiya dannykh: uchebnoe posobie dlya studentov vysshikh uchebnykh zavedenii, obuchayushchikhsya po napravleniyu i po spetsial'nostyam psikhologii [Mathematical methods of psychological research. Analysis and interpretation of data: A textbook for psychology students]. Saint Petersburg: Rech', 2010. 388 p. (In Russ.).
  14. Parfenov V.A., Yakhno N.N., Davydov O.S. et al. Khronicheskaya nespetsificheskaya (skeletno-myshechnaya) poyasnichnaya bol'. Rekomendatsii Rossiiskogo obshchestva po izucheniyu boli (ROIB) [Chronic nonspecific (musculoskeletal) low back pain. Guidelines of the Russian Society for the Study of Pain (RSSP)]. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics, 2019, vol. 11, no. 2S, pp. 7–16. DOI: 10.14412/2074-2711-2019-2S-7-16. (In Russ., in Engl.)
  15. Podchufarova E.V., Yakhno N.N. Bol' v spine: rukovodstvo [Back Pain: A Guide]. Moscow: GEOTAR-Media, 2014. 368 p. (In Russ.).
  16. Poroshina E. G., Vologdina I.V. Trudnyi patsient: uchebnoe posobie [Difficult patient: A study guide]. Saint Petersburg: NWSMU n.a. I.I. Mechnikov, 2017. 36 p. (In Russ.).
  17. Rasskazova E.I., Machulina A.I., Kovrov G.V. et al. Kognitivnaya sostavlyayushchaya reprezentatsii lecheniya i kachestvo zhizni pri somaticheskikh zabolevaniyakh [Cognitive representation component of treatment and quality of life with somatic diseases]. Psikhicheskoe zdorov'e = Mental Health, 2014, vol. 12, no. 1, pp. 43–51. (In Russ., abstr. in Engl.).
  18. Rasskazova E.I., Tkhostov A.Sh. Aprobatsiya metodik diagnostiki lokusa kontrolya prichin bolezni i lecheniya i samoehffektivnosti v otnoshenii lecheniya [Validation of illness- and treatment-related locus of control scale and treatment-related self-efficacy scale]. Vestnik Yuzhno-Ural'skogo Gosudarstvennogo universiteta. Seriya «Psikhologiya» = Bulletin of the South Ural State University. Series «Psychology», 2016, vol. 9, no. 1, pp. 71–83. DOI: 10.14529/psy160108 (In Russ., abstr. in Engl.).
  19. Serikov A.A., Iordanishvili A.K. Izmenenie vnutrennei kartiny bolezni v protsesse lecheniya zabolevanii visochno-nizhnechelyustnogo sustava [Сhanges in the internal diseases picture during of the temporomandibular joint disease treatment]. Vestnik rossiiskoi voenno-meditsinskoi akademii = Bulletin of the Russian Military Medical Academy, 2019, no. 3 (67), pp. 46–51. (In Russ., abstr. in Engl.).
  20. Starostina E.G. Volodina M.N. Rol' komplaentnosti v vedenii bol'nykh s diabetom [The role of compliance in the management of patients with diabetes]. Russkii meditsinskii zhurnal = Russian Medical Journal, 2015, vol. 23, no. 8, pp. 477–480. (In Russ.).
  21. Sushilova A.G., Belousova L.N. Izuchenie zavisimosti urovnya komplaentnosti ot vnutrennei kartiny bolezni, koping-strategii, trevogi i depressii patsientov s zabolevaniyami zheludochno-kishechnogo trakta [Studying the dependence of the level of compliance on the internal picture of the disease, coping strategies, anxiety and depression in patients with diseases of the gastrointestinal tract]. In A.V. Mel'tser, I.Sh. Yakubova (eds.), Profilakticheskaya meditsina — 2019: sbornik nauchnykh trudov Vserossiiskoi nauchno-prakticheskoi konferentsii s mezhdunarodnym uchastiem = Preventive medicine – 2019: Collection of scientific papers of the All-Russian scientific and practical conference with international participation. St. Petersburg, November, 14–15, 2019. St. Petersburg: NWSMU n.a. I.I. Mechnikov, 2019. Pp. 169–176. (In Russ.).
  22. Tihonova A.S., Pogonchenkova I.V., Kotel’nikova A.V. et al. Motivatsiya k lecheniyu u patsientov s khronicheskoi bol'yu v spine [Treatment motivation in patients with chronic low back pain]. Kremlevskaya meditsina. Klinicheskii vestnik = Kremlin Medicine Journal, 2022, no. 2, pp. 48-51. (In Russ., abstr. in Engl.).
  23. Tsvetkova I.V. Problema psikhologicheskogo izucheniya vnutrennei kartiny zdorov'ya [The problem of studying the inner picture of health]. Psikhologicheskie issledovaniya = Psychological Studies, 2012, vol. 21, no. 1, pp. 11. URL: http://psystudy.ru. 0421200116/0011 (Accessed: 09.12.2022). (In Russ., abstr. in Engl.).
  24. Shkaly i algoritmy v obshchevrachebnoi praktike: prakticheskoe rukovodstvo [Scales and algorithms in general medical practice: A practical guide]. E.V. Dotsenko (ed.). Moscow: GEOTAR-Media, 2020. 208 p. DOI: 10.33029/9704-5867-9-SHK-2020-1-208. (In Russ.).
  25. Shkaly, testy i oprosniki v meditsinskoi reabilitatsii: ruk. dlya vrachei i nauch. rabotnikov [Scales, tests and questionnaries in medical rehabilitation]. A.N. Belova, O.N. Shchepetova (eds.). Moscow: Antidor, 2001. 439 p. (In Russ.).
  26. Shtrahova A.V. Psikhosemantika boli v strukture vnutrennei kartiny bolezni u nevrologicheskikh bol'nykh [Psychosemantics of pain in the structure of the internal picture of disease in neurological patients]. Vestnik Yuzhno-Ural'skogo universiteta. Seriya «Psikhologiya» = Bulletin of the South Ural State University. Series «Psychology». 2009, no. 30 (163), pp. 76–82. URL: https://cyberleninka.ru/article/n/psihosemantika-boli-v-strukture-vnutrenney-kartiny-bolezni-u-nevrologicheskih-bolnyh (Accessed: 09.12.2022). (In Russ., abstr. in Engl.).
  27. Yaltonskii V.M., Abrosimov I.N., Andrushkevich T.D. et al. Issledovanie parametrov vnutrennei kartiny bolezni u patsientov revmatologicheskogo profilya [Parameters of the Subjective Pattern of Disease in Rheumatoid Patients]. Rossiiskii psikhologicheskii zhurnal = Russian Psychological Journal, 2020, vol. 17, no. 1, pp. 15–26. DOI: 10.21702/rpj.2020.1.2 (In Russ., abstr. in Engl.).
  28. Bandura A. Self–efficacy mechanism in human agency. American Psychologist, 1982, vol. 37, no. 2, pp. 122–147. DOI: 10.1037/0003-066X.37.2.122

Information About the Authors

Anastasia V. Kotelnikova, PhD in Psychology, Senior Research Assistant of Medical Rehabilitation Department, Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine of Moscow Healthcare Department, Moscow, Russia, ORCID: https://orcid.org/0000-0003-1584-4815, e-mail: pav-kotelnikov@ya.ru

Anastasia A. Kukshina, Doctor of Medicine, Leading Researcher of Medical Rehabilitation Department, Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine of Moscow Healthcare Department, Moscow, Russia, ORCID: https://orcid.org/0000-0002-2290-3687, e-mail: kukshina@list.ru

Anastasia S. Tihonova, medical psychologist of the Branch 3, Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine of Moscow Healthcare Department, Moscow, Russia, ORCID: https://orcid.org/0000-0001-7693-9397, e-mail: seyli1992@list.ru

Tatiana S. Buzina, Doctor of Psychology, Moscow State Medical and Dental University named after A.I. Evdokimov of the Ministry of health of the Russian Federation, Moscow, Russia, ORCID: https://orcid.org/0000-0002-8834-251X, e-mail: tbuzina@gmail.com

Metrics

Views

Total: 671
Previous month: 45
Current month: 31

Downloads

Total: 201
Previous month: 12
Current month: 7