NeuroRehabilitation - Volume 14, issue 2

Authors: Martelli, Michael F. | Zasler, Nathan D.

Article Type: Introduction

DOI: 10.3233/NRE-2000-14201

Citation: NeuroRehabilitation, vol. 14, no. 2, pp. 55-55, 2000

Authors: Nicholson, Keith

Article Type: Research Article

Abstract: This paper, written from the perspective of a psychologist working in a tertiary care chronic pain program, presents an overview of chronic pain with suggestions as to what may be important directions for research and treatment in the future. It is suggested that the monumental problem of chronic pain needs to be better appreciated, that both biological and psychosocial factors contributing to presentation need to be better understood, and that the most fruitful avenue of research may be an exploration of the interface between psychosocial and biological components, i.e., the neurobiological substrate mediating psychological effects or the nature of brain-behavior …relationships involved in chronic pain. A method to assist in the differentiation of central from peripheral and organic from psychosocial components, and the outline of a novel neuropsychobiological model are described. Show more

DOI: 10.3233/NRE-2000-14202

Citation: NeuroRehabilitation, vol. 14, no. 2, pp. 57-67, 2000

Authors: Gonzales, Vera A. | Martelli, Michael F. | Baker, Jeff M.

Article Type: Research Article

Abstract: Chronic pain is one of the most prevalent and costly health care problems and variability is the rule more than the exception in terms of pain related outcomes. Clearly, psychological factors such as depression, anxiety, post traumatic stress, excessive somatic thoughts and a variety of psychiatric syndromes are recognized as actively contributing to a patient's perceptions and responses to pain and can represent significant potential impediments to functioning and optimal health care outcome. As a result, it is becoming increasingly common, and even required by many programs, for individuals who seek treatment for pain to undergo a comprehensive assessment that …evaluates not only their medical findings, but also beliefs about their condition, coping strategies, psychological adjustment, activity level and quality of life. Psychological assessment instruments that provide information about a person's physiological, behavioral, and cognitive-affective functioning in terms of vulnerabilities and strengths can be a valuable tool for treatment providers. In the present paper, a biopsychosocial conceptual model is employed to provide an overview of a method and approach in evaluating patients with chronic pain, toward the goal of facilitating optimal outcome and management of pain syndromes. Show more

Keywords: psychological assessment, chronic pain, neuropathic pain, coping, disability

DOI: 10.3233/NRE-2000-14203

Citation: NeuroRehabilitation, vol. 14, no. 2, pp. 69-83, 2000

Authors: Kirsch, Daniel L. | Smith, Ray B.

Article Type: Research Article

Abstract: Cranial Electrotherapy Stimulation (CES) has a growing history of applications in rehabilitation medicine in the United States dating back to early 1970. As a recognized non-drug treatment of anxiety, depression and insomnia, CES gained its first major application in the field of addiction treatment and rehabilitation. By the mid 1980s research was showing additional important uses of CES in the treatment of closed head injured patients, and in paraplegic and quadriplegic patients. The most recent research is showing CES to be highly effective in the management of chronic pain patients. It may be elevating the pain threshold due to its …stress reducing effects when anxiety and depression are reduced below clinical levels. Modern theorists of a pain neuromatrix in the cerebral cortex may provide an additional basis for understanding CES mechanisms in the control of pain related disorders. Show more

DOI: 10.3233/NRE-2000-14204

Citation: NeuroRehabilitation, vol. 14, no. 2, pp. 85-94, 2000

Authors: Nicholson, Keith

Article Type: Research Article

Abstract: There has been considerable controversy concerning the problem of the persisting post-concussive syndrome and whether cognitive or other sequelae might be attributed to the effects of brain injury or other causes. Headache is the predominant problem in virtually all surveys of the post-concussive syndrome. It is suggested that pain and related problems may account for most of the difficulties in those presenting with the persisting post-concussive syndrome or other cases in which mild to moderate brain injury is suspected. A survey of the literature concerning the relationship of pain, cognition and traumatic brain injury indicates that cognitive difficulties are common …in acute or chronic pain, with or without any indication of brain injury. However, numerous methodological problems are apparent and there is clearly need for further study. Consideration is given both to psychosocial and neurobiological effects underlying any such relationships. Show more

DOI: 10.3233/NRE-2000-14205

Citation: NeuroRehabilitation, vol. 14, no. 2, pp. 95-103, 2000

Authors: Martelli, Michael F. | Liljedahl, Erika L. | Nicholson, Keith | Zasler, Nathan D.

Article Type: Research Article

Abstract: The expanding Internet has become an increasingly valuable tool for world wide sharing of information. Health care professionals, patients, lay persons, family members and others are afforded instant access to masses of information and almost unlimited resources on virtually any topic, as well as an almost seamless vehicle for communication. This new medium offers tremendous implications for health care. However, the absence of a single clearinghouse, a single search procedure or guarantee of accuracy often make information access efforts challenging, confusing and frustrating. The present paper provides a brief introduction aimed at increasing appreciation of the Internet and enhancing its …utility with regard to chronic pain and its management and offers rudimentary guidelines for efficient accessing of information. Finally, it presents the results of a comprehensive search including nearly 200 useful Internet web links for professionals, patients, family members and other interested persons who assess, treat or cope with chronic pain. Identified resources include numerous organizations, medical, psychological assessment and practical treatment strategies, assessment and treatment reviews, support groups, list serve groups for patients and professionals, advocacy resources, news and assistive technology resources. Special emphasis is given to useful resources to assist professionals treating persons with chronic pain, as well as resources that can assist persons challenged by chronic pain. Show more

Keywords: chronic pain, Internet, chronic pain management, world wide web

DOI: 10.3233/NRE-2000-14206

Citation: NeuroRehabilitation, vol. 14, no. 2, pp. 105-121, 2000

Authors: Collins, William G.

Article Type: Book Review

DOI: 10.3233/NRE-2000-14207

Citation: NeuroRehabilitation, vol. 14, no. 2, pp. 123-123, 2000