Chronic Pain in Adolescents Associated with Psychosocial Factor - Research Paper Example

? Chronic Pain in Adolescents Associated With Psychosocial Factor Anxiety is believed to be one of the common psychiatric diseases in adolescents and may develop secondary to influencing biological mechanisms associated with adolescents’ specific medical illness in reaction to being ill. Exposure to chronic pain early in life and frequent painful medical procedures are associated with fear and anxiety during subsequent procedures; hence anxiety and fear can produce serious consequences in adolescents have chronic pain or life threatening illness. Therefore, proper identification and treatment of anxiety disorders is crucial since it may improve not only the psychiatric symptoms but also physical symptoms. Though anxiety is normal to life stressors and uncertainties, it is more problematic since its intensity and duration start to exert impacts on one’s functioning and quality of life. Among adolescents, anxiety involves both psychological and physical fields whose symptoms can be uneven and endure daily. In adolescents, psychological symptoms of anxiety include being worried, feeling tense and being unable to turn off their thoughts without being able to identify a source resulting in these intrusive and upsetting symptoms. The symptoms may be difficult to sort in adolescents who have chronic medical conditions, which apart from the daily worries regarding school, peers and family have to face uncertainty regarding their health status (Patton and Viner, 2007). For instance, epilepsy can aggravate anxiety where chronic pain in adolescents offers an instance of continuous disclosure to aversive medical measures. Adolescents with medical illnesses have been diagnosed with entire spectrum of anxiety disorders like acute stress disorder, panic disorder and social phobias and obsessive-compulsive disorder (Ekinci et al, 2009). Chronic concern and anxiety can diminish immune functions thus making an individual more vulnerable to diseases, which increase the cruelty of the preexisting physical pain or illness. It is worth noting that most chronic illnesses is never predicted by the severity of the chronic pain, but rather other psychosocial factors like social support, parental adjustment among others (Straub, 2012). Symptoms related to actual physical illnesses among adolescents result in frequent triggers for panic attacks as well as anxiety disorders. Moreover, chronic pain like epilepsy or diabetes that may require close monitoring can result in medical crisis since they make adolescents more anxious because of being away from home and care givers; hence, contributing to increased separation anxiety in adolescents with chronic illnesses. Therefore, interactions among disease-related and psychosocial factors are believed to be responsible for the increased rates of anxiety disorders in adolescents with chronic pain (Eccleston et al, 2004). Many medical conditions and medications can directly result in anxiety like neurological, cardiac and metabolic disorders can produce signs that are similar to anxiety symptoms in adolescents. Since there are no specialized tools for gauging anxiety symptoms and disorders among the medically ill adolescents, it is hard to assess occurrence rate in the population precisely. Incidences of anxiety vary in accordance with the medical illness, age of patients and whether trait or state anxiety is measured, which makes it impossible to compare rates of symptoms and disorders in adolescents. In general, moderate-to-severe anxiety is considered to influence symptoms, medical result and treatment devotion and the aptitude of adolescents to cope with illnesses. Hence proper, identification and treatment of anxiety disorders can reduce both psychiatric and physical symptoms (Waddell, 2002). Since anxiety disorders can have serious consequences in adolescents with chronic pain or life threatening medical illnesses, prompt identification and treating these disorders is crucial. Behavioral together with cognitive techniques like guided imagery and relaxation as well as psychotropic medication are useful in treating worry mayhems in pediatric patients. However, little data exists regarding treatment of anxiety in adolescent with chronic pains; treatment can be inferred from healing anxiety disorders in adolescents without chronic pains. Moreover, managing anxiety and stress relies on the level of impairment disorder targeted as well as the developmental considerations. Cognitive behavioral therapy is an efficient treatment in mood disorders like depression and anxiety disorders prevalent in adolescents. The goal of cognitive behavioral therapy is helping adolescents recognize cognitively distorted thoughts, test these thought and teach them skills for challenging irrational thoughts and replacing them with more rational ones (Pao and Bosk, 2011). Using behavioral techniques and cognitive behavioral therapy in an ill population involves addressing several areas that include initial distress reaction in diagnosis, anxiety and pain in treatment, disease related chronic pain, adherence to medial regimen, coexisting psychosocial distress as well as the provision of social skills for reintroduction of school and life after or with the disease. Cognitive behavioral therapy techniques are useful in helping adolescents in managing pain since they are able to visualize as much as required when undergoing painful procedure. Characters of transformation and transition vital to adolescence imply that adolescents can comprise a group in which concise psychodynamic therapy is appropriate. However, it true there that few models regarding time-limited therapy exist for young people in therapeutic modality, which reflects the extensively perceived difficulty in appealing to and sustaining teenagers in therapy. It has been suggested that an aspect of this difficulty is the gap between adolescents and adults with regard to their perception of time because even for young people a short-term intervention can seem entrapping and endless; moreover, for others the notion of time limit can seem to be oppressive imposition on freedom. Radically changed social contexts for adolescents generate fresh and different psychological tasks and require certain qualities in order to negotiate transitions that are extended, less structured and more uncertain. These increase pressure to make individualized decisions enabling them to think flexibly about future plans and develop narratives that make sense of the experiences. Pathway into adulthood has become more complex, while psychoanalytic thinking richly theorizes the development from puberty to adulthood. Nevertheless, psychoanalytic therapy offers opportunities for linking internal, relational, individual and social aspects of the processes of adolescence like recognizing key transitional markers and the way they are experienced individually. Time-limited psychodynamic therapy provides opportunities for offering structure and focus in the therapy where these are socially absent, confusing or concentrated on one aspect of experience like education. The model of time-limited therapy is based on and adapts a recognized model for psychodynamic psychotherapy in adolescents, which was articulated for several years in Tavistock Clinic’s Adolescent Department (De Blecourt et al, 2008). Based on this model of adolescent process, therapeutic practices with adolescents involve distinctive techniques and necessitate different approaches from those working in children and the elderly. The process of engagement with adolescent means taking into account the tension between being dependent and more separate, projection of intense feelings and possibility of offering space to check sees whether and how the adolescent attends therapy. Thus, therapists have to mind adolescent’s anxiety regarding being in therapy and be ready to spend some time recognizing and talking about it and aiming at identifying the qualities of anxiety brought by every adolescent. Hence, maintaining an adolescent in therapy involves containing the anxiety about the process by talking about the structure of therapy and the thinking of the therapist, as well as aiming at understanding deep anxieties brought by starting therapy and the difficulties the young individuals faced that led him or her to end up in the therapy (Briggs, 2010). Bio-psychosocial model is an effective model for assessing and treating chronic pain problems in adolescents, since the model considers patient’s functioning to be under the influence of biological, psychological and social factors. Psychosocial factors are recognized in relation to pain-experience and pain-behavior because various authors stress the significance of the relation between social factors and pain. In this approach, adolescents have to accept their current pain and the fact that the pain may never disappear although the goal of the approach is the achievement of functional improved. Therefore, in order to achieve this, it is essential explaining the situation to the adolescent and the implication for them in future, as well as their responsibilities in coping with the pain. References Briggs, S. (2010). Time-limited psychodynamic psychotherapy for adolescents and young adults. Journal Of Social Work Practice, 24(2), 181-195. De Blecourt, A. A., Preuper, H., Van Der Schans, C. P., Groothoff, J. W., & Reneman, M. F. (2008). Preliminary evaluation of a multidisciplinary pain management program for children and adolescents with chronic musculoskeletal pain. Disability & Rehabilitation, 30(1), 13-20. Eccleston C, Crombez G, Scotford A, Clinch J, Connell H. (2004). Adolescent chronic pain: patterns and predictors of emotional distress in adolescents with chronic pain and their parents. Pain 108:221 – 229 Ekinci O, Titus JB, Rodopman AA, et al. (2009). Depression and anxiety in children and adolescents with epilepsy: prevalence, risk factors, and treatment. 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