On the role of psychological and social factors in pharmacological analgesia: A psychosocial moderation hypothesis.

Abstract

Identifying safe and efficient pharmaceutical pain treatments remains an enduring challenge. However, despite significant advancements in pharmacological pain management, the inconsistent effectiveness of many analgesics between people remains puzzling. To address this problem, we introduce a new hypothesis suggesting that psychosocial factors exacerbate or attenuate (i.e., moderate) pain-relieving effects of analgesics: the psychosocial moderation hypothesis of pharmacological analgesia. According to this hypothesis, psychosocial factors can be categorized into three groups: (a) dispositional psychological factors, (b) situational cognitive or affective factors, and (c) contextual and social factors. The psychosocial moderation hypothesis is intended to extend the biopsychosocial model of pain to pharmacological pain management, with the goals to deepen the understanding of how analgesic drugs function and to open new paths to pain research and management beyond the traditional biomedical approach in pharmacological pain treatment. This hypothesis thus points toward a more comprehensive, psychosocial approach to pharmacological pain management and encourages the development of analgesic models that take the psychosocial context of analgesic consumers into account. We hope that this hypothesis will stimulate novel empirical and theoretical efforts in identifying the most beneficial analgesic for different types of people in different situations and, thus, to optimize analgesic dosing to provide adequate pharmacological pain relief while minimizing adverse side effects. (PsycInfo Database Record (c) 2025 APA, all rights reserved).