The Aword

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Cognitive Impairment in Chronic Illness

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"Pain has a habit of blurring the edges of reality." Chris Wells, The Pain Relief Handbook

Difficulties in thinking abilities are a disconcerting and troublesome offshoot of chronic illness that are perhaps underestimated.

Certainly, this sort of problem is rarely addressed directly until it becomes a major issue.

Nevertheless, even relatively minor impairment can have a significant impact upon quality of life. Chronic illness leaves us with little room for manoeuvre at the best of times, so we do need our faculties to be functioning at the best possible level.

How do we know if this is becoming a problem? Well, often it is a very slow and insidious sort of trouble that most people don't notice.

Often the person feels they are having difficulties with memory or thinking clearly, but are told by family and friends that they shouldn't over-react and that everyone forgets things from time to time. Alternatively, family or friends might notice an unusual level of absent-mindedness and be concerned, whereas the individual is unaware.

What sort of difficulties might we expect?

"Pain demands attention, interrupts behaviour and is difficult to disengage from" Prof. Dr. Geert Crombez   ([1])

Professor Crombez has identified several variables that amplify the interruptive function of pain have been identified:

  • Intensity,
  • Novelty,
  • Unpredictability and
  • The threat value of pain.
He has performed studies that suggest, "Attentional interference was best predicted by the interaction between pain severity and pain-related fear."

Professor Stephen Morley of Leeds University gave a seminar in March 2000, in which he discussed redesigning psychological treatments for chronic pain.

He proposed 3 categories that are important in chronic pain management: ([2])

  1. Interruption: when pain interrupts thought/behaviour flow
  2. Interference: when pain interferes with a task/goal achievement
  3. Identity: the pain changes one's core sense of self.