header image

[Sign Up Now] to Receive Our FREE Daily SCVTV-SCVNews Digest by E-Mail

Inside
Weather


 
Calendar
Today in
S.C.V. History
November 7
1940 - William S. Hart deeds land for theater at Spruce & 11th Street to American Legion [story]
American Theater


As one of his faculty colleagues put it, Adam Swenson feels your pain, philosophically speaking.

A professor of philosophy at California State University, Northridge, Swenson has devoted more than a decade of research, and a doctoral dissertation, to philosophical and ethical issues surrounding pain and its treatment.

In 2013, he formed an interdisciplinary collaboration with researchers at the University of Southern California Pain Center to explore those issues.

Swenson and his colleagues studied how the physician’s impressions of their pain patients can affect decisions to prescribe powerful opioid medications — or not. They have submitted their findings to a leading scientific journal.

 

CSUN philosophy professor Adam Swenson conducted a pain study that reveals trust issues between patients and their doctors.

CSUN philosophy professor Adam Swenson conducted a pain study that reveals trust issues between patients and their doctors.

“There are no fully objective measures (for pain),” Swenson said. “With a heart condition, you can take an EKG reading, but there’s not much like that with pain conditions. At some point, the clinician has to make an assessment about how much pain a patient is in. And that’s going to depend largely on what they tell you.

 

“While (the field of) pain medicine is increasingly interdisciplinary, treatments for people with extreme pain will often involve powerful narcotics or certification for disability,” he said of chronic pain conditions such as severe migraines, post-traumatic injury pain and neuropathic diseases.

“So, at the end of the day, the clinician has to decide whether to write a prescription for oxycodone or fentanyl-based largely on whether they trust the patient, a stranger, to be telling the truth,” Swenson said.

“On top of that, (patients have) an incentive to malinger or lie, in order to get powerful narcotics or disability certification,” he said. “But when we looked into the research on this, there was a lot about what affects the patient’s trust in their physician — but very little about the physician trusting (his or her) patients.”

Swenson collaborated with Dr. Steven Richeimer, director of the USC Pain Center; Faye Weinstein, director of pain management psychology for the center; and Doerte Junghaenel, a behavioral scientist at the USC Dornsife Center for Economic and Social Research.

The group used as their foundation a survey conducted for the National Academies Institute of Medicine’s groundbreaking 2011 report, “Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education and Research.”

They obtained a copy of about 5,000 responses to the survey, which included long narratives from Americans living with chronic pain conditions. With Swenson’s computer programming skills, the team organized and processed the narratives to identify those they could use to explore responses to the ways pain patients present their own stories.

They then built their own online survey and advertised it among pain patient groups and physicians in 2015.

They received nearly 1,000 responses.

Their survey asked respondents to assess the trustworthiness of selected narratives’ authors, as well as their perceptions of the author’s personality and whether they seemed, for example, likable, histrionic, appreciative (of the doctor), depressed or stoic.

“I built a web app, which let us randomize the order of the questions and narratives so that we could probe how perceptions of personality relate to judgments of medically relevant trustworthiness,” he said. “For example, one of our hypotheses was that whether someone comes across as stoic or histrionic would affect whether they were trusted to follow the physician’s instructions.”

They found that patients who came across as dramatic correlated very strongly with not seeming trustworthy, he said.

“If you seem stoic, you seem more trustworthy about pain,” Swenson said. “We also asked about likability, and we found that (a patient’s likability) also correlates really strongly with trustworthiness.”

In the study, patients who seemed depressed also were deemed more untrustworthy by clinicians and non-medical personnel. It’s a Catch-22 for some patients in pain: “The more upbeat a pain patient seems, and not complaining, the more likely (the physician is) to trust them,” Swenson said.

He noted that patient advocacy groups provide tips on how to be a “good patient,” such as bringing health records, asking questions and not treating the doctor as the enemy.

Physicians must be more aware of biases in their own treatment decisions, Swenson said.

“Our results suggest that clinicians should be cognizant of, for example, the role the patient’s tendency to be dramatic may be playing in their decision-making,” he said. “They may need to slow down and ask themselves: ‘This person strikes me as a complainer. Am I sure that’s not making me discount what they’re telling me?’

“We all rightly have a lot of respect for doctors — we see them as practical scientists,” he continued. “We trust them with our lives, quite literally. When I talk about this with people sometimes, they’re just (shocked) by the idea that your doctor might not trust you. But doctors are human beings, too.”

The team’s findings emerged under the cloud of the country’s pervasive opioid epidemic. When Swenson first started studying pain in 2003 as a doctoral student, he said, years of under-treatment of pain had finally given way to doctors being told, “Trust your patient and prescribe accordingly.”

Now, the opioid epidemic is killing so many Americans that it’s pervasive across age groups.

“We need to figure out how to help doctors strike the right balance (in prescribing),” Swenson said. “(Learning) what affects trust in patients will help.”

“There’s something about pain that makes it particularly inscrutable,” he said. “Elaine Scarry, who wrote the book, ‘The Body in Pain,’ has this great line: ‘To feel pain is to know but to hear of pain is to doubt.’ At some level, we just don’t want to believe that it could suck that much. We’re naturally skeptical because you can’t see inside anyone else’s head. But in the case of pain, you don’t want to.”

Comment On This Story
COMMENT POLICY: We welcome comments from individuals and businesses. All comments are moderated. Comments are subject to rejection if they are vulgar, combative, or in poor taste.
REAL NAMES ONLY: All posters must use their real individual or business name. This applies equally to Twitter account holders who use a nickname.

No Comments

    Leave a Comment


    HIGHER EDUCATION LINKS
    LOCAL COLLEGE HEADLINES
    Wednesday, Nov 6, 2024
    California State University, Northridge’s CSUN-al Gardening series returns this month just in time to prepare for fall planting.
    Wednesday, Nov 6, 2024
    For the fourth year in a row, California State University, Northridge has been named a Fulbright HSI Leader by the U.S. Department of State’s Bureau of Educational and Cultural Affairs.
    Tuesday, Nov 5, 2024
    The Santa Clarita Valley Food Pantry has announced a newly-formed partnership with California Institute of the Arts and its Basic Needs Center.
    Tuesday, Nov 5, 2024
    For the fourth consecutive time, the College of the Canyons Contracts, Procurement and Risk Management department received a 2024 Annual Achievement of Excellence in Procurement award from the National Procurement Institute, Inc.
    Thursday, Oct 31, 2024
    The entertainment and media news magazine TheWrap released its annual ranking of the top United States film schools, with the California Institue of the Arts School of Film/Video nabbing the #7 ranking for the 2024-25 cycle.
    Keep Up With Our Facebook

    Latest Additions to SCVNews.com
    Did you know that our local Santa Clarita Public Library offers passport acceptance services? Whether you’re planning a vacation, studying abroad or reconnecting with family, the Santa Clarita Public Library is here to support your journey.
    Jason Gibbs | Get Your Passport at the Santa Clarita Public Library
    Parents and caregivers are invited to Empowered Families Workshops hosted by the Child & Family Center’s Prevention and Outreach team in collaboration with First Presbyterian Church of Newhall beginning 2-3:30 p.m. Sunday, Nov. 10 with a workshop on Social Media and mental health.
    Nov. 10: Child & Family Center, First Presbyterian Church Collab for Workshops
    Samuel Dixon Family Health Center, Inc. has announced that it was awarded a $1.1 million grant from the Department of Health and Human Services Health Resources and Services Administration to add new services that will include substance use disorder treatment programs.
    Samuel Dixon Awarded 1.1 Million Grant for SUD Program
    The American Cancer Society Relay for Life of Santa Clarita Valley will host its annual holiday boutique fundraiser, 10 a.m.-3 p.m. Saturday, Nov. 23, at Santa Clarita United Methodist Church
    Nov. 23: ACS Relay for Life SCV Holiday Boutique
    The Santa Clarita Veteran Services Collaborative has announced the "Bringing it Home" fundraiser, an exclusive wine and hors d'oeuvre event hosted by Salt Creek Grille, will be held Thursday, Nov. 21.
    Nov. 21: Salt Creek Grille, Veteran Services Collaborative Host Fundraiser
    The U.S. Postal Service announced its recommended mailing and shipping dates for holiday mail and packages. The following are recommended send-by dates for expected delivery before Dec. 25.
    USPS Announces Holiday Mailing, Shipping Dates
    1940 - William S. Hart deeds land for theater at Spruce & 11th Street to American Legion [story]
    American Theater
    The closest race of the election is for Santa Clarita City Council. Patsy Ayala was leading Tim Burkhart by 37 votes at the close of business Wednesday, 3,219 to 3,182. More absentee ballots remain to be counted.
    Local Election Results as of Wednesday Evening
    Due to projected power shutoffs related to the current wind advisory, the Child & Family Center’s Centre Pointe Pkwy location, will be closed for in-person services beginning 5 pm Wednesday
    Child & Family Center’s Centre Pointe Pkwy Location Closes Due to Power Shutoffs
    Beginning Wednesday, November 13, crews will begin the construction of median modifications, paving, grinding and overlay operations along portions of McBean Parkway at Newhall Ranch Road.
    Upcoming Lane Closures on McBean Parkway and Newhall Ranch Road
    The California Highway Patrol is proud to announce it received a $350,000 grant to address the growing issue of distracted driving on California roads.  
    CHP Receives Grant to Combat Adult Distracted Driving in California
    The Los Angeles County Economic Development Corporation has once again recognized the city of Santa Clarita as a finalist for the prestigious 2024 "Most Business-Friendly City" award in the category of large cities (population over 60,000).
    City of Santa Clarita Named 2024 Most Business-Friendly City Finalist
    The County of Los Angeles is experiencing critical fire weather and is under a Particularly Dangerous Situation Red Flag advisory from now until Friday evening. .
    Animal Care and Control Urges Emergency Pet Preparedness
    The city of Santa Clarita is pleased to announce the release of the 2025-2026 Notice of Funding Availability and has scheduled informational meetings for organizations interested in applying for 2025-2026 Community Development Block Grant funding.
    Santa Clarita Non-Profits Invited to Apply for 2025-2026 Funding Cycle
    California State University, Northridge’s CSUN-al Gardening series returns this month just in time to prepare for fall planting.
    CSUN-al Garden Class to Get Ready for Fall Planting
    The Los Angeles County Board of Supervisors unanimously approved a motion introduced by Supervisor Kathryn Barger and co-authored by Board Chair Lindsey P. Horvath
    Supes Support Expansion of Tax Credit Program for Entertainment Sector
    Local educational performing arts charity Mission Opera, together with Oksana Foundation and Bella Cucina Italian Restaurant, is excited to announce “Bella Notte,” a new monthly event starting this Fall that blends the worlds of Italian fine dining, live opera, and community support.
    Nov. 23: “Bella Notte” Italian Night Comes to Santa Clarita
    For the fourth year in a row, California State University, Northridge has been named a Fulbright HSI Leader by the U.S. Department of State’s Bureau of Educational and Cultural Affairs.
    CSUN Named a Fulbright HSI Leader For a Fourth Year in a Row
    Thompson Von Tungeln Trust and Estate Lawyers will host a free successor trustee training workshop on Saturday, Nov. 9, from 10 a.m. to noon at the Hyatt Regency Valencia, 24500 Town Center Drive, Valencia, Calif. 91355.
    Nov. 9: Free Successor Trustee Training Workshop
    No. 12 College of the Canyons football scored 24 points, highlighted by a 95-yard kickoff return from sophomore Da'Marrie Smith, in what turned out to be a decisive second quarter to outlast visiting Moorpark College 27-21 on Saturday, Nov. 2 at Cougar Stadium.
    No. 12 Canyons Outlasts Moorpark College 27-21
    Unofficial election results for the 2024 General Election as of Tuesday, Nov. 5 at 11:21 p.m.
    2024 General Election Santa Clarita Races
    1976 - Horse turds and peace pipes: Acton Turkey War with AM radio jock Dick Whittington ends in a draw [story]
    Turkey war
    The Santa Clarita Valley Food Pantry has announced a newly-formed partnership with California Institute of the Arts and its Basic Needs Center.
    SCV Food Pantry Partnership with CalArts to Feed Students
    SCVNews.com