Abstract
This article shows a complex viewpoint on present models of psychological processes in chronic pain that stems from researches based on neurophysiologic and psychological experiments or a multivariate analysis of clinical data. Modern conceptions of psychological changes are based on Melzack - Wall's Gate Controle Theory, Lazarus and Folkman's cognitive theory of stress, and the concept of learned pain behavior of Wilbert E.
Fordyce. Two groups of models follow these above mentioned conceptions: A model of consecutive stages of psychological changes in people with chronic pain (Wade, Dougherty, Archer, Price, 1996; Knotek, Knotkova 2008), and models that focus on feedback processes during the development of psychological changes in people with chronic pain (survey in Asmundson, Vlaeyen, Crombez, 2004).
A new model that includes essential aspects of both above mentioned models has been recently tested (Knotek, 2009). The article proposes an extended theoretical model that includes two triggering processes, pain and cognitive processing of pain.
The main stages of psychological processes consist of fear and observation of pain, pain assessment and coping with pain, changes of affects and motivation, and adaptive or maladaptive behavior. The changes of affects and motivation have an influence on self-perception which via feedback influences cognitive processing of pain.
The basic vision for the future research of chronic pain is the Neuromatrix Theory of Pain of Roland Melzack (2005) that sees pain as multidimensional experience caused by neurosignature (patterns of impulses of neural network that represent body - self neuromatrix in the brain).