Chronic back pain and rheumatoid arthritis: predicting pain and disability from cognitive variables

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presentation and course of chronic pain. 110 men with chronic low back pain were studied. The disability patients (unlimited compensation) were more likely to be using narcotics and sedatives and to display more pain behaviors. 51 patients provided follow-up data at 12 months following completion of treatment. No statistically significant differences were found among the 3 groups in terms of pain experience. medication or activity at this time. The study suggests that unlimited compensation may be associated with greater medication use and more pain behaviors. The low yield to follow-up limits any further generalization from the data, but the authors believe that unlimited compensation may delay a return to work.

PSYCHOLOGY Chronic

back pain and rheumatoid arthritis: predicting pain and disability from cognitive variables. -~I-1. Flor and D.C. Turk, J. Behav. Med., 11 (1988). This study examined the relationship of situation-specific pain-related self-statements, convictions of personal control, pain severity, and disability levels in chronic back pain and rheumatoid arthritis patients. Data analyses revealed that the more general and the specific cognitive variables were more strongly related to pain and disability than disease-related variables. These variables combined explained between 32 and 60% of the variance in pain and disability respectively. These findings provide further support for cognitive-behavioral formulations of the chronic pain experience.

R.N. Empirically derived Symptom Checklist 90 subgroups of chronic pain patients: a cluster analysis. Jamison, D.L. Rock and W.C.V. Parris, J. Behav. Med., I1 (1988). This study applied cluster analysis procedures to identify homogeneous subgroups of chronic pain patients responses to the Symptom Checklist 90 (SCL-90). Subjects were 453 chronic pain patients who had undergone physician evaluations and ratings of pain pathology and pain behavior. Three distinct replicable SCL-90 profiles were identified. These represented high, medium and low scores on the SCL-90-R instrument. While the subgroups failed to differ in demographic characteristics, compensation status, or pain duration or ratings, patients in the high-profile subgroup showed the most emotional distress. reported the most interference with activities and had high ratings of pain behavior. The authors conclude that the SCL-90 may be a useful method for assessing chronic pain patients. The occurrence chronic

of maladaptive

low back pain patients.

health-related ~ K. Richard,

behaviors

and teacher-rated

conduct

problems

in children

of

J. Behav. Med., 11 (1988). This study examined children of chronic pain patients to determine whether they may exhibit learned pain or illness behavior patterns. The study compared children of chronic low back pain patients to children of diabetic patients and a control group of children. The results indicated that children of the back pain patients exhibited a higher level of behavior the authors believed was learned through observation or interaction with a parent having low back pain than children in the diabetic or control groups. Psychometric

analysis

of the audiovisual

taxonomy

for assessing

pain behavior

in chronic

back pain patients.

C.L. Kleinke and A.S. Spangler, Jr., J. Behav. Med., 1 (1988). This study examined the characteristics of an audiovisual taxonomy for recording pain behavior. Videotaped records of pain behavior were taken from 60 chronic back pain patients at the beginning and end of an inpatient multidisciplinary pain program. Data analyses revealed that a composite score from the taxonomy showed adequate frequency and reliability and was sensitive to treatment effects. The study