Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

Psychosomatic Part I

Psychosomatic refers to one or more psychological or behavioral factors that affect an individuals general medical condition. These psychological or behavioral factors may contribute to the development of a medical condition, they may exacerbate the condition or they may delay recovery from a medical condition. The diagnostic code for this is 316.0 Psychological Factor Affecting Medical Condition and is a frequent diagnosis with injured workers.”]

The final three are often key elements pre-existing injury and pivotal in determining recovery from injury:

4. Maladaptive Health Behaviors Affecting Working Related (e.g. orthopedic) Injury – Include sedentary lifestyle, overeating, drug abuse and/or excessive alcohol use. Thus, the individual has, or has developed, maladaptive ways of spending his/her days. Time may be spent eating large, unhealthy and frequent meals. It may also include failure to comply with dietary restrictions that have led to diabetes and hypertension. The individual makes no attempts at exercise and engages in unsafe health practices, fails to seek regular medical care and may self-treat conditions that should be treated by a physician.

5. Stress-Related Physiological Response Affecting Work-Related Injury. Physical responses due to environmental stressors complicate the treatment of a neurological or orthopedic problem. Tension type headaches and stress-induced back pain are the clearest example. There may be tension in the home against which the patient continually braces for confrontation. As a result, he/she may have muscle contraction pain which then complicates the diagnosis of injury-related pain.

6. Unspecified Factors Affecting Work-Related Injury. This includes complex behavioral patterns, response styles and personality characteristics which combine to complicate the course of recovery. An example of this would be a dependent individual, obese and borderline hypertensive, seeking comfort from food, angered when this maladaptive behavior is disrupted by family and developing chest pain in response to the stressor.

The psychosomatic (also called psychophysiologic) interplay of mind and body lead to frequent complications in the treatment and course of recovery for an injured worker.

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