[Psychological models of pain : Critical comments on the Gate Contro Theory and Proposal of a transactional multicomponent process model of pain.].

In clinical pychology, the Gate Control Theory of pain (GCT) is considered a milestone among the psychological approaches to pain. In this paper ten critical issues are raised against the GCT. It is argued that GCT should be abandoned as a basis for the psychological study of pain. GCT is not compatible with numerous neurophysiological results. Furthermore, it claims to provide specific explanations for psychological phenomena that have long been known. Finally, GCT is inappropriate for the analysis of psychological pain processing and the varied consequences of pain. As an alternative to GCT, a comprehensive process model is proposed that incorporates the many consequences of pain. In this "micro-macro-model of persistent and intermittent chronic pain", pain is conceptualized as a transactional multicomponent process. First, the basic features of the model are outlined. Second, the methodological consequences that accompany the model are considered. Third, research evidence on the validity of the model is given, in particular with regard to the relationship between pain experience and subjective stress, as well as between pain experience and coping with the pain. Finally, further research questions are formulated.