Factors Related to Pain Perception and Pain Disability

Many biopsychosocial factors related to pain and pain disability have been researched. Biological processes related to pain perception include nervous system reactivity and recovery in response to stress and symptoms. Psychological processes include temperamental tendencies, such as attentional biases toward symptom-related stimuli and coping strate-

gies employed. Social factors include environmental stressors, especially chronic stress, and parental responses to children's symptom behavior. For example, children with recurrent abdominal pain exhibit hyperreactive sympathetic nervous system arousal in response to environmental stressors (hypersensitive perception of gastrointestinal stimuli and a lower threshold for pain), disrupted parasympathetic recovery from stressors, and hypervigilance to internal and external pain cues (Compas and Boyer 2001; Di Lorenzo et al. 2001; Duarte et al. 1999; Thomsen et al. 2002). Biochemical changes in the afferent neurons of the central and enteric nervous systems, influenced by cognitive processes and other sensations, are hypothesized to be related to the reduced pain threshold. In the following subsections, I review some of the factors found to influence pain perception and disability.

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