ABSTRACT
Psychological factors associated with the onset, maintenance, and treatment of chronic pain have long been established. However, much of this literature focuses on specific pain disorders including low back pain, headache, and arthritis. In recent years, a significant literature has developed examining psychological variables in abdominal and pelvic pain, and to a lesser degree, noncardiac chest pain (NCCP). Because psychological variables have been shown to influence each of these painful conditions, there is potential value to including psychological treatments in the management of these complex disorders. Following a brief discussion of the psychological factors associated with these disorders, we will review the different psychological treatments studied in each condition. The focus of our discussion of abdominal pain will be primarily on psychological treatments for irritable bowel syndrome (IBS) because it is the most common and commonly studied type of chronic abdominal pain in adults. Similarly, studies that examine a broad diagnosis of pelvic pain related to menstruation or the reproductive organs will be reviewed. A separate literature has developed examining vulvodynia, or chronic vulvar discomfort, which has recently been conceptualized as a chronically painful condition [chronic pelvic pain (CPP)] that requires a shift in paradigm from an acute, infection-focused model to a more comprehensive, interdisciplinary conceptualization (1). The psychological treatment of NCCP will also be included in our discussion, though this body of literature is not well developed.
