Do threats and reassurances reside in the biological, psychological or social domain? A qualitative study in adults and young people with chronic pain
Published 12th August 2024
Learning about biopsychosocial contributions to a sensitised pain system is a key target of many pain management programs. The ‘Protectometer’ is a tool used to explore personal threats and reassurances, known as ‘DIMs’ (danger in me) and ‘SIMs’ (safety in me’), to guide personalised pain management. While used widely in clinical practice, there has been no research about the types of DIMs and SIMs elicited, and potential differences across the lifespan for people with chronic pain.
Results of this qualitative study offer useful insights for clinicians working in pain rehabilitation. DIMs and SIMs could be grouped into four main themes of: ‘Engaging with the environment’, ‘In my body’, ‘My emotional health’, and ‘Activities and behaviours’, reflecting a wide range of contributing factors to pain and pain relief. Distributions across the biopsychosocial framework were analysed, with the highest number of SIMs found in the social domain for both young people (47%) and adults (49%).
Young people’s DIMs were predominantly in the psychological (44%) and social (43%) domains, while adult DIMs were fairly evenly spread across the biological (37%), psychological (27%) and social domains (36%). Findings reveal age-related differences to pain perception, and highlight the importance of the social domain, comprising of the physical environment (places), social environment (people), and meaningful occupations (activities) in pain management therapies for both adults and young people.
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Citation: Kennedy, H., Harvie, D. S., & Coppieters, M. W. (2024). Do threats and reassurances reside in the biological, psychological or social domain? A qualitative study in adults and young people with chronic pain. British Journal of Pain. https://doi.org/10.1177/20494637241263291
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