A systematic review of pain drawing literature-should pain drawings be used for psychological screening?
Carnes, D, Ashby, D and Underwood, M (2006) A systematic review of pain drawing literature-should pain drawings be used for psychological screening? Clinical Journal of Pain (5). pp. 449-459. ISSN 1536-5409
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Abstract
Introduction: The use of pain drawings to identify the psychological 'state' of patients in terms of distress, depression, somatisation and anxiety has been advocated. They are used as a psychological screen before considering treatments, such as surgery. For pain drawings to be clinically useful as a psychological screen they need good positive and negative predictive values. We systematically reviewed the literature that directly compared pain drawing scoring systems with measures of psychological state. Method: We searched 12 medical and social science databases, using key words and their derivatives. Nineteen articles were suitable for analysis. The majority focused on low back pain (79%) and secondary and tertiary care (90%). Pain drawings were evaluated against psychological tools testing: personality (MMPI); somatisation (MSPQ, IBQ); depression (Zung); anxiety (SF36) and distress (GHQ). Results: Three studies concluded that the association between pain drawings and psychological state was sufficient for clinical use; of these only one showed reasonable sensitivity and specificity data. Six reported a statistical association and 10/19 studies reported inconclusive results and weak association. More clinically relevant, sensitivity data ranged from 24-93%, specificity 44-91%, positive predictive values 28-93% and negative predictive values 35-92%.The range and magnitude of these predictive statistics is too wide and inconsistent to accept the pain drawing as a clinical diagnostic tool to predict psychological state. Conclusions: We conclude that the available data do not support the assumption that unusual pain drawings or extensive marking indicate disturbed psychological state. There is no high quality evidence to support pain-drawing use as a psychological assessment tool; therefore pain drawings are not recommended for this purpose.
| Item Type: | Article |
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| Divisions: | Faculty of Medicine, Health and Life Sciences > School of Medicine |
| Depositing User: | Dr Hilary Abbey |
| Date Deposited: | 25 Mar 2021 15:29 |
| Last Modified: | 25 Mar 2021 15:29 |
| URI: | https://uco.repository.guildhe.ac.uk/id/eprint/147 |
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