Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression


Exit: Life after injury is not ideal, but it is often much like a paid vacation. The 1944 French novel “Huis Clos” (trans: “No Exit”), by existentialist Jean Paul-Sartre, was required reading in many French (and English) college curricula. The play essentially reminds us that there is no greater hell than being trapped with other people …

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Relatedness to injury: There are far too many times that when treating an injured worker, I come upon serious health problems that are being ignored. The most obvious are obesity, hypertension and diabetes. Due to a variety of factors including health habits, lack of family concern and financial limitations, early signs of disease are not …

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Injury: If a wealthy man were to win the Lottery, his spending behavior is unlikely to be significantly altered. He was already in touch with his material and investment needs and was deprived of neither. A sudden influx of lottery money is most often applied to the same rules and limits that he has acquired. …

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Gain: “The concept of secondary gain is a frequently addressed observation as to the benefits a patient receives from an illness or injury. The term is sometimes used as an indictment of the patient. Since s/he derives gain from the physical complaint, some feel that the complaint is less important and warrants less concern. Tertiary gain …

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Unmet Expectations:  “He feels that surgery did not go as planned, that the outcome was poor, yet we have the surgical notes which indicate that it was a successful lumbar fusion. Why the discrepancy?” “There can be a vast difference between OBJECTIVE surgical outcome and the patient’s SUBJECTIVE (emotional) response to that outcome. From an objective …

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Satisfaction for patient and provider: A survey in 2013 reported that: “An alarming 70% of those surveyed in a recent …
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Checkers vs. Chess: “It may be difficult to trace the origins of healthcare becoming a competitive sport where doctors …
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Partial Malingering

A patient can have a valid disorder yet still be malingering (falsifying complaints for purposes of tangible gain). Malingering …
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