Keynote Dr. Melanie Noel - Diagnostic Uncertainty In Chronic Pain

About: Living with chronic pain is fraught with uncertainty. Diagnostic uncertainty (DU; i.e., the perception that the explanation or cause of a condition is inaccurate and/or the belief that something more serious is causing the condition that doctors have not yet found) is reported by up to 40% of adults and youth (and their parents) with chronic pain and it is a core source of emotional distress. Nevertheless, research on diagnostic uncertainty is limited. Dr. Noel will present new quantitative and qualitative longitudinal data on the sources and consequences of DU in individuals with chronic pain and their caregivers.

The high prevalence of DU among parents, youth, and adults with chronic pain as well as influences of past medical experiences and clinician communication, and deleterious outcomes (worse mental health and pain) will be presented. Additionally, research findings on clinician’s experience of uncertainty in the context of treating children with chronic pain and their families will be presented.

Finally, new observational research examining actual clinician-family interactions in initial clinical intake appointments within tertiary chronic pain programs will be presented.

This will illustrate ways of communicating with patients who live with chronic pain and their families (reassurance, validation, explanations for pain) that are, and are not, beneficial in alleviating uncertainty and promoting behavior change.

Citations:

1) Neville, A., Kopala-Sibley, D., *Soltani, S., Asmundson, G.J.G., Jordan, A., Carleton, R.N., Yeates, K.O., Schulte, F., Noel, M. (2021). A longitudinal examination of the interpersonal fear avoidance model of pain: The role of intolerance of uncertainty. PAIN.

2) Neville, A., Noel, M., Clinch, J., Pincus, T., Jordan, A. (2021). ‘Drawing a line in the sand’: Clinician diagnostic uncertainty in pediatric chronic pain. Eur J Pain. 25(2), 430-441.

3) Neville, A., Jordan, A., Pincus, T., *Nania, C., Schulte, F., Yeates, K.O., Noel, M. (2020). Diagnostic uncertainty in pediatric chronic pain: Nature, prevalence, and consequences. PAIN Rep. 5(6), 871.

4) Neville, A., Jordan, A., Beveridge, J. K., Pincus, T., & Noel, M. (2019). Diagnostic uncertainty in youth with chronic pain and their parents. Journal of Pain. doi: 10.1016/j.jpain.2019.03.004.

5) Pincus, T., Noel, M., Jordan, A., & Serbic, D. (2018). Perceived diagnostic uncertainty in pediatric chronic pain. Pain, 159(7), 1198-1201.

Melanie Noel, PhD, RPsych is an Associate Professor of Clinical Psychology at the University of Calgary and a Full Member of the Alberta Children's Hospital Research Institute and the Hotchkiss Brain Institute. She directs the Alberta Children’s Pain Research Lab within the Vi Riddell Pain & Rehabilitation Centre at the Alberta Children’s Hospital in Canada.

Dr. Noel’s expertise is on children’s memories for pain and co-occurring mental health issues and pediatric chronic pain. She published guiding conceptual models of children’s pain memory development, co-occurring PTSD and chronic pain, and fear-avoidance (109 peer-reviewed papers, H index = 31).

In recognition of her contributions to advancing knowledge of the psychological aspects of children’s pain, Dr. Noel received early career awards from the International Association for the Study of Pain (IASP), the Canadian Pain Society, the American Pain Society, the Canadian Psychological Association, and the Society of Pediatric Psychology.

She was named Avenue Magazine Calgary’s Top 40 Under 40 (Class of 2017) and a Killam Emerging Research Leader (2020).