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Psychologische Mechanismen der Chronifizierung – Konsequenzen für die Prävention

  • Chapter
Schmerzpsychotherapie

Zusammenfassung

In den vergangenen 15 Jahren wurde, v. a. im Rahmen prospektiver Längsschnittstudien, nachgewiesen, dass zahlreichen psychologischen und psychobiologischen Mechanismen eine bedeutende Rolle im Prozess der Chronifizierung akuter Schmerzen zukommt. Hierzu zählen eine depressive Stimmungslage, ungünstige Formen der emotionalen, kognitiven und verhaltensbezogenen Schmerzverarbeitung sowie chronische Stressoren im beruflichen und privaten Alltagsleben. Bei der Aufrechterhaltung dieser Faktoren kommt Prozessen der klassischen und operanten Konditionierung zentrale Bedeutung zu. In jüngerer Zeit werden darüber hinaus verstärkt iatrogene Prozesse beschrieben, die im Rahmen der medizinischen Behandlung von Schmerzpatienten eine Chronifizierung begünstigen. Aktuelle Leitlinien zur Behandlung akuter Schmerzen (z. B. akuter Rückenschmerzen) sehen als Konsequenz eine frühzeitige Diagnostik psychologischer Risikofaktoren (»yellow flags«) vor, deren Berücksichtigung zur Prävention der Schmerzchronifizierung beitragen soll. Erste Screeninginstrumente liegen für die Individualdiagnostik vor. Ebenso gibt es erste empirische Befunde aus kontrollierten, randomisierten Interventionsstudien bei Rückenschmerzen, die darauf hindeuten, das risikofaktorenbasierte kognitiv-verhaltenstherapeutische Interventionen bei Hochrisikopatienten den Chronifizierungsprozess verhindern können.

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Author information

Authors and Affiliations

  1. Schmerztagesklinik und -Ambulanz, Universitätsmedizin Göttingen, Göttingen, 37075, Robert-Koch-Str. 40

    Prof. Dr. Michael Pfingsten

  2. DRK Schmerz-Zentrum Mainz, Mainz, Steig 16, 55131

    Dr. phil. Joachim Korb

  3. Abt. für Medizinische Psychologie und Medizinische Soziologie, Ruhr-Universität Bochum Universitätsstr, Bochum, 150, 44801

    Prof. Dr. Monika Hasenbring

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  1. Prof. Dr. Michael Pfingsten
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  2. Dr. phil. Joachim Korb
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  3. Prof. Dr. Monika Hasenbring
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Editors and Affiliations

  1. Georg-Elias-Müller-Institut für Psychologie, Georg-August-Universität, Göttingen, Goßlerstr. 14, 37073

    Birgit Kröner-Herwig

  2. Abteilung für Schmerztherapie Berufsgenossenschaftliches, Universitätsklinikum Bergmannsheil GmbH, Bochum, Bürkle-de-la-Camp-Platz 1, 44789

    Jule Frettlöh

  3. Fachbereich Psychologie, Psychotherapeutische Hochschulambulanz Verhaltenstherapie, Universität Hamburg, Hamburg, Von-Melle-Park 5, 20146

    Regine Klinger

  4. DRK Schmerz-Zentrum Mainz, Mainz, Steig 16, 55131

    Paul Nilges (Leitender Psychologe) (Leitender Psychologe)

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Pfingsten, M., Korb, J., Hasenbring, M. (2011). Psychologische Mechanismen der Chronifizierung – Konsequenzen für die Prävention. In: Kröner-Herwig, B., Frettlöh, J., Klinger, R., Nilges, P. (eds) Schmerzpsychotherapie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-12783-0_7

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