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J Pain. 2014 May;15(5):550.e1-10. doi: 10.1016/j.jpain.2014.02.001. Epub 2014 Feb 15.

Internalized stigma in people living with chronic pain.

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Research School of Psychology, Australian National University, Canberra, Australia. Electronic address:
Research School of Psychology, Australian National University, Canberra, Australia.
Northern Clinical School Kolling Institute of Medical Research, St. Leonards, New South Wales, Australia.


Although persistent pain occurs in a sociocultural context, the influence of personal devaluation and invalidation is often neglected. As such, the present study sought to consider whether individuals' experience, perception, or anticipation of negative social reactions to their pain may become internalized and affect the self. To examine this issue, 92 adults with chronic pain responded to a questionnaire exploring the presence of internalized stigma and its association with a range of psychological consequences. As predicted, a large percentage of people with chronic pain (38%) endorsed the experience of internalized stigma. The results showed that internalized stigma has a negative relationship with self-esteem and pain self-efficacy, after controlling for depression. Internalized stigma was also associated with cognitive functioning in relation to pain, in terms of a greater tendency to catastrophize about pain and a reduced sense of personal control over pain. Overall, this study presents a new finding regarding the application of internalized stigma to a chronic pain population. It offers a means of extending our understanding of chronic pain's psychosocial domain. Implications are discussed in terms of the potential to inform clinical treatment and resiliency into the future.


This article presents a novel finding regarding the presence of internalized stigma among people living with chronic pain. Internalized stigma is strongly associated with indicators of patient outcome. It presents an area for future work with the aim to improve our understanding and treatment of people living with pain.


Pain; internalized; psychosocial factors; stigma

[Indexed for MEDLINE]

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