Practice recommendations for contextualizing explanations of headache pain within a biopsychosocial model.

Abstract

The current study aimed to identify non-dismissive language and synthesize practice recommendations for medical providers to use when discussing potential psychological etiologies of chronic pain. Community-recruited emerging adults (18- to 25-year-olds; N = 138; 68 % female) participated in the current study as part of a larger online survey. Participants were randomly assigned to read either a "dismissive" (i.e., attributed pain to primarily psychological etiologies) or "biopsychosocial" (i.e., provided a more nuanced explanation of the complex interplay between psychological and physiological etiologies of pain) vignette describing hypothetical patient-provider interactions regarding -chronic daily headache complaints. Participants who read the biopsychosocial vignette and male participants reported significantly more positive reactions (e.g., more satisfaction, higher likelihood of continued care). Qualitative results showed that participants who read the dismissive vignette were more likely to feel their time had been wasted and obligated to explain their pain further. Hypothetical provider explanations of psychological etiologies of chronic daily headache pain were received more positively when contextualized within a biopsychosocial framework. This article presents practice recommendations for how medical providers should introduce potential psychological etiologies of a patient's headache pain experience in a non-dismissive manner to decrease the likelihood of provider-generated pain dismissal experiences.