Chronic pain has been shown to be associated with heightened neuroticism and lowered self-esteem (36, 37). These and other effects on personality are presumably the resuJt of persistent pain for they are often reversed when it is relieved(38). At the same time they signal an undermining of personality that, no doubt, makes a contribution of its own to
pain. A vicious circle may also result fromthe social consequences of pain (35)