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Changing Face of Pain: Evolution of Pain Research in Psychosomatic Medicine

From Duke University Medical Center (F.J.K., C.L.E., D.S.) and Duke University (F.J.K., A.L.H.B., A.K.A.,), Durham, North Carolina; Wayne State University (M.A.L., D.J.M.), Detroit, Michigan; University of North Carolina (J.W.C.), Chapel Hill, North Carolina; University of Lousiville School of Medicine (J.L.S.), Louisville, Kentucky; and Ohio University (L.F.), Athens, Ohio.

Address reprint requests to: Francis J. Keefe, PhD, Duke University Medical Center, Box 3159, Durham, NC 27710. Email: keefe003{at}mc.duke.edu

OBJECTIVE: This article provides an overview of how psychosomatic research on pain has evolved over the past 60 years as exemplified by studies published in Psychosomatic Medicine.

METHODS: Each issue of Psychosomatic Medicine from 1939 to 1999 was reviewed to identify papers that dealt with pain, painful medical conditions, or pain management. A total of 150 papers were identified and grouped into seven categories: 1) case studies; 2) studies of personality traits and other individual differences; 3) psychophysiological studies of pain; 4) studies using pain induction techniques; 5) studies examining the relation of relation of race, ethnicity, and culture to pain; 6) studies of pain unique to women; and 7) studies examining treatments for pain.

RESULTS: A substantial number of studies on pain and painful conditions were published in the Journal in the 1940s and 1950s, and that number has almost doubled in the most recent full decade of the Journal. Within the pain area, however, the topics of interest to psychosomatic researchers have been, and continue to be, quite diverse. Although publications on certain methods or topics (eg, psychodynamic case studies, physiological correlates of pain) have decreased over time, publications on other topics (eg, personality traits and individual differences) have remained relatively constant, and publications on still other topics (eg, studies using pain induction techniques; studies of race, ethnicity, and culture; women’s pain; and treatment studies) have flourished recently.

CONCLUSIONS: Considered overall, the results of our review suggest that the face of pain research published in PM has changed considerably in the past 60 years. Given the ongoing commitment of psychosomatic researchers to this area, we expect this evolution to continue in the years to come.

Key Words: pain, • pain assessment, • pain management, • chronic pain.

Abbreviations: ACTH = adrenocorticotropic hormone;; CBT = cognitive-behavioral therapy;; EEG = electroencephalography;; EMG = electromyography;; MDQ = Menstrual Distress Questionnaire;; MMPI = Minnesota Multiphasic Personality Inventory;; PM = Psychosomatic Medicine;; PMSS = premenstrual symptoms and syndromes;; RCT = randomized, controlled trial;; TMD = temporomandibular disorder.

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