|
Continuing Dental Education (CDE)
Current Concepts in Chronic Pain - A Bio-Psychosocial Model - Professor Samuel Dworkin Abstract A biobehavioral model of chronic pain is offered that has provided a rationale and schema for epidemiologic and clinical pain research conducted over more than 15 years. This model suggests that physiologic, psychologic and social factors interact in different ways at different stages in the development of pain and pain dysfunction, resulting in large variability in how pain is expressed as subjective report, overt behavior and psychosocial disability, within the same person across time. One implication of the model is that augmentation of pain at the levels of perception, appraisal and behavior, as well as changes in pathobiologic mechanisms may help explain discrepancies between the subjective state of the chronic pain patient and the extent of noxious stimulation or the extent of tissue damage. This presentation focuses on epidemiologic and clinical studies of chronic pain, focusing on evidence from temporomandibular disorder (TMD) pain, to consider potential contributions of epidemiology and biobehavioral research to understanding and managing chronic pain. The findings reviewed suggest that no single factor in isolation -- pathophysiologic, psychologic or social -- will adequately explain chronic pain status. Variability in the expression of pain across time and the interaction of biologic, psychologic and social factors in the development of pain and pain dysfunction requires dynamic and multilevel ecologic concepts. Critical issues for future epidemiologic and clinical research in chronic pain and associated dysfunction are identified. The Speaker SAMUEL F. DWORKIN, DDS, PhD Samuel F. Dworkin, DDS, PhD, is a dentist and clinical psychologist, who maintained a general dental practice in NYC for 16 years. He became a full-time dental teacher/researcher after completing his PhD in Clinical Psychology under an NIH Special Fellowship. Dr. Dworkin is presently Professor in the Departments of Oral Medicine, School of Dentistry and Psychiatry and Behavioral Sciences, School of Medicine, at the University of Washington. He has had a distinguished career as a dental educator at New York University and Columbia University before coming to the University of Washington as Associate Dean for Academic Affairs, a position he held from 1974-1978. He is an active clinical researcher who has been continuously NIH funded for two decades and serves as attending clinical psychologist at University Hospital, where he is an active clinician and clinical psychiatric training supervisor. Dr. Dworkin directs a large NIH funded program of research in chronic dental and orofacial pain. His clinical and research interests now focus on how physical findings and clinical signs are related to the emotional and behavioral status of patients with chronic orofacial pain and the role that biobehaviorally-based treatments may play in chronic pain management. Dr. Dworkin has contributed more than 150 articles to the scientific literature, and co-authored or edited several texts relating behavioral science and clinical dentistry. He is a charter member of the American Pain Society and the International Association for the Study of Pain and is a member of numerous professional organizations representing both Dentistry and Psychology. Dr Dworkin has been honored as Founder’s Day Scholar, New York University and recipient of the Distinguished Scientist Award of the Behavioral Science and Health Services Group of the International Association for Dental Research, a group for which he has served twice as President.
08 February 2001, Thursday Time 1930 - 2100 hrs Venue
Organiser
Chairman Dr Adrian Yap NOTE This lecture is accredited by the SMC/SDC for CME/CDE for 1 point back to INDEX
|
