Chronic pelvic pain is a common presenting complaint in gynecology clinics. In a proportion of cases no pathology or sufficient pathology can be found to account for the level of complaint. This paper reviews the evidence on the psychological characteristics of patients presenting with chronic pelvic pain without obvious pathology. Methodological considerations are identified in order to guide future research. There is a need for prospective studies, in which women with pelvic pain of whatever etiology are evaluated, in order to provide contextual data and to identify predictors of treatment response.
Get full access to this article
View all access options for this article.
References
1.
HyslopR. S.Some Thoughts on Pelvic Pain, Australian & New Zealand Journal of Obstetrics & Gynaecology, 12, pp. 40–42, 1972.
2.
Working Party of the Confidential Enquiry into Gynaecological Laporscopy, British Journal of Obstetrics & Gynaecology, 85, p. 401, 1978.
3.
MillsW. G.The Enigma of Pelvic Pain, Journal of the Royal Society of Medicine, 71, pp. 257–260, 1978.
4.
LeavittF.GarronC.Validity of a Back Pain Classification Scale for Detecting Psychological Disturbances as Measured by the MMPI, Journal of Clinical Psychology, 36, pp. 186–189, 1980.
5.
SternbachR. A., Pain Patients, Traits and Treatments, Academic Press, New York, 1974.
6.
LundbergW. I.WallJ. E.MathersJ. E.Laporoscopy in the Evaluation of Pelvic Pain, Obstetrics & Gynecology, 42, pp. 872–876, 1973.
7.
TaylorH. C., Chronic Pelivc Pain, in Progress in Gynaecology, MeigsJ. V.SturgisS. H. (eds.), Vol. 3, Grune & Stratton, New York, 1957.
8.
TaylorH. C.Vascular Congestion and Hyperemesia: I Physiologic Basis and History of the Concept, American Journal of Obstetrics & Gynecology, 57, pp. 211–230, 1949.
9.
DuncanC. H.TaylorH. C.A Psychosomatic Study of Pelvic Congestion, American Journal of Obstetrics & Gynecology, 64, pp. 1–12, 1952.
10.
RabkinJ. G.StreuningE. L.Life Events, Stress and Illnesses, Science, 194, pp. 1013–1016, 1976.
11.
RenaerM.Chronic Pelvic Pain Without Obvious Organic Pathology in Women, European Journal of Obstetrics, Gynaecology & Reproductive Biology, 10:6, pp. 415–463, 1980.
12.
Gidro-FrankL.GordonT.TaylorH. C.Pelvic Pain and Female Identity: A Survey of Emotional Factors in 40 Patients, American Journal of Obstetrics & Gynecology, 79, pp. 1184–1202, 1960.
13.
GrossR. J.DoerrH.CaldirolaD.GuzinskiG.RipleyH. S.Borderline Syndrome and Incest in Chronic Pain Patients, International Journal of Psychiatry in Medicine, 10:1, pp. 79–86, 1980–81.
14.
ReadingA. E.CampbellS.CoxD. N., “Is Pelvic Pain Ever Functional?” presented at Scientific Meeting of the Royal College of Obstetricians & Gynaecologists, London, May, 1981.
15.
BensonR. C.HansonK. H.MatarazzoJ. D.Atypical Pelvic Pain in Women: Gynecologic and Psychiatric Considerations, American Journal of Obstetrics & Gynecology, 77, pp. 806–825, 1959.
16.
BeardW. W.BelseyE. M.LiebermanB. A.WilkinsonJ. C. M.Pelvic Pain in Women, Obstetrics & Gynecology, 128, pp. 566–570, 1977.
17.
RenaerM.VertommenH.NijsP.WagemansL.van HemelrijckT.Psychological Aspects of Chronic Pelvic Pain in Women, American Journal of Obstetrics & Gynecology, 134, pp. 75–80, 1979.
18.
KleinhausS.HeinK.SheranM.DoelyS. J.Laporscopy for the Diagnosis and Treatment of Abdominal Pain in Adolescent Girls, Archives of Surgery, 112, pp. 1178–1179, 1977.
19.
GoldsteinD. P.de CholnokyC.LeventhalJ. M.EmansS. J.New Insights into the Old Problem of Chronic Pelvic Pain, Journal of Pediatric Surgery, 14, pp. 675–679, 1979.
20.
CoxG. B.ChapmanC. R.BlackR. G.The MMPI and Chronic Pain: The Diagnosis of Psychogenic Pain, Journal of Behavioral Medicine, 1, pp. 437–443, 1978.
21.
WoodfordeJ. M.MerskeyH.Personality Traits of Patients with Chronic Pain, Journal of Psychosomatic research, 16, pp. 167–172, 1972.
22.
SternbachR. A., Clinical Aspects of Pain, in The Psychology of Pain, SternbackR. A. (ed.), Raven Press, New York, 1978.
23.
SternbachR. A.TimmermansG.Personality Changes Associated with Reduction of Pain, Pain, 1, pp. 177–181, 1975.
24.
GreenhortJ. H.SternbachR. A., Conjoint Treatment of Chronic Pain, in Advances in Neurology, BonicaJ. J. (ed.), Vol. 4, Raven Press, New York, 1974.
25.
PhillipsC., A Psychological Analysis of Tension Headache, in Contributions to Medical Psychology, RachmanS. (ed.), Vol. 1, Pergamon Press, Oxford, 1977.
26.
MelzackR.The McGill Pain Questionnaire: Major Properties and Scoring Methods, Pain, 1, pp. 277–299, 1975.
27.
PilowskyI., Pain as Abnormal Illness Behavior, Journal of Human Stress, pp. 22–27, June 1978.
28.
BeecherH. K., The Meaning of Subjective Experiences, Oxford University Press, 1959.
29.
WolffB. B.LangleyS.Cultural Factors and the Response to Pain: A Review, American Anthropologist, 70, pp. 494–501, 1968.
30.
CraigK. D.BestH.ReithG.Social Determinants of the Reports of Pain in the Absence of Pain Stimulation, Canadian Journal of Behavioral Science, 6, pp. 167–177, 1974.
31.
BondM. R.GlynnJ. P.ThomasD. G.The Relationship Between Pain and Personality in Patients Receiving Pentazocine After Surgery, Journal of Psychosomatic Research, 20, pp. 369–381, 1976.
32.
FordyceW. S., Behavioral Methods for Chronic Pain and Illness, C. V. Mosby Co., St. Louis, 1976.
33.
GoldzieherJ. N.The Incidence of Side Effects with Oral Contraceptives and IUDs, American Journal of Obstetrics & Gynecology, 102, pp. 91–97, 1968.
34.
FrankE.AndersonC.RubinsteinM. S.Frequency of Sexual Thoughts in Normal Couples, New England Journal of Medicine, 299, pp. 111–115, 1978.
35.
ForrestA. J.WolkindS. N.Masked Depression in Men with Low Back Pain, Rheumatology & Rehabilitation, 13, pp. 148–153, 1974.
36.
KaplanH. S., The New Sex Therapy, Bruner-Mazel, New York, 1976.
37.
LennaneK. J.LennaneR. J.Alleged Psychogenic Disorders in Women: A Possible Manifestation of Sexual Prejudice, New England Journal of Medicine, 288, pp. 288–292, 1973.
38.
SternbachR. A.FordyceW. S., Psychogenic Pain, in The Management of Pain, BonicaJ. J. (ed.), 2nd ed., Lea and Febiger, Philadelphia, 1975.
39.
PinskyJ. J., Chronic Intractable Benign Pain: A Syndrome and Its Treatment with Intensive Short Term Group Psychotherapy, Journal of Human Stress, pp. 17–21, September 1978.
40.
ThomasM. R.LyttleD.Patient Expectations About Success of Treatment and Reported Relief from Low Back Pain, Journal of Psychosomatic Research, 24, pp. 297–301, 1980.
41.
HillH. E.KornetskyC. H.FlanaryH. G.WiklerA.Studies of Anxiety Associated with Anticipation of Pain, Archives of Neurology, 67, pp. 612–618, 1952.
42.
BeecherH. K., The Placebo Effect as a Nonspecific Force Surrounding Disease and the Treatment of Disease, in Pain: Basic Principles, Pharmacology, TherapyR.JongenKeidelW. D.HerzA.SteichelsC.PayneJ. P.BurtR. A. P. (eds.), Geirg Thieme, Stuttgart, 1972.
43.
ReadingA. E., The Implications of Attribution Theory for the Management of Chronic Pain, in Applications of Attribution Theory to Clinical and Educational Practice, BrewinC.AntakiC. (eds.), Academic Press, London, in press.
44.
MelzackR.The McGill Pain Questionnaire: Major Properties and Scoring Methods, Pain, 1, pp. 277–299, 1975.
45.
BrehmJ. W., A Theory of Psychological Reactance, Academic Press, New York, 1966.
46.
WattsF. N.AustinS.PowellG. E.The Modification of Abnormal Beliefs, British Journal of Medical Psychology, 46, pp. 359–363, 1973.
47.
ReadingA. E.RawM. T.The Treatment of Mandibular Dysfunction Pain: Possible Applications of Psychological Methods, British Dental Journal, 6, pp. 201–206, 1976.
48.
BarberJ.Rapid Induction Analgesia: A Clinical Report, American Journal of Clinical Hypnosis, 19, pp. 138–147, 1977.
49.
BelarC.Stress Management of Chronic Pain, Journal of Florida MA, 67, pp. 487–490, 1980.
50.
FordyceW. S.StegerJ. C., Behavioral Management of Chronic Pain, in Behavioral Medicine: Theory and Practice, PomerleauO.BradyJ. P. (eds.), Wilkins & Wilkins, Baltimore, 1979.
