The objectives of the psychological evaluation of the patient with chronic pain are not to determine whether the patient's pain is real or imagined (all pain is "real'') but rather:
• to determine the degree of psychological adaptation to chronic pain which includes mood state, coping skills, effect on family, and particularly level of physical functioning;
• to evaluate the patient's premorbid psychological state and personality factors and its effect on onset and etiology of pain;
• to establish the role of psychological factors in the etiology, maintenance, and exacerbation of pain;
• to formulate a DSM-IV diagnosis;
• to devise a treatment plan in conjunction with the patient and the rest of the multidisciplinary team;
• to predict outcome of invasive medical procedures, such as surgical implantation of spinal cord stimulators or continuous infusion pumps;
• to determine which psychological and medical interventions would be most appropriate for which patients;
• to identify environmental reinforcers of chronic pain and illness behaviors, such as family, litigation status, and disability insurance status;
• to evaluate the likelihood of the development of chronic pain-related disability.
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