Skip to main content

Advertisement

Log in

Predicting subjective disability in chronic pain patients

  • Published:
International Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Subjective disability is considered as the variable that reflects the impact of chronic pain on a patient’s life. This study examines the questions of which syndrome or patient characteristics determine subjective disability and whether there are differences between samples of patients with chronic headaches and low back pain. Direct pain variables and depression, pain coping strategies, and pain-related self-statements (including catastrophizing) are introduced into multivariate regression analyses as potential predictors of disability using a sample of 151 pain patients. Disability is not predicted by pain severity in patients with headaches or back pain. Psychological variables, especially coping strategies, are far more influential. Coping explains more variance in disability in the headache sample than in the chronic low back pain group, whereas depression is more relevant for the degree of disability in the back pain sample.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Brands, A. M., & Schmidt, A. J. (1987). Learning processes in the persistence behavior of chronic low back pain patients with repealed acute pain stimulation. Pain, 31, 53–64.

    Article  Google Scholar 

  • Campbell, D. T., & Fiske, D. W. (1959). Convergent and discriminant validation by the multitrail-multimethod matrix. Psychological Bulletin, 56, 81–105.

    Article  PubMed  Google Scholar 

  • Crook, J., Tunks, E., Kalaher, S., & Roberts, J. (1988). Coping with persistent pain: A comparison of persistent pain sufferers in a special pain clinic and in a family practice clinic. Pain, 34, 175–184.

    Article  PubMed  Google Scholar 

  • Flor, H., Behle, D. J., & Birbaumer, N. (1993). Assessment of pain-retated cognitions in chronic pain patients. Behaviour, Research and Therapy, 31, 63–73.

    Article  Google Scholar 

  • Flor, H., Rudy, T. E., Birbaumer, N., Streit, B., & Schugens, M. M. (1990). Zur Anwendbarkeit des West Haven-Yale Multidimensional Pain Inventory im Deutschen Sprachraum. Daten zur Reliabilität und Validität des MPI-D [The applicability of the West Haven-Yale Multidimensional Pain Inventory in German-speaking countries: Data on reliability and validity of the MPI-D]. Der Schmerz. 4, 82–87.

    Article  PubMed  Google Scholar 

  • Flor, H., & Turk, D. C. (1988). Chronic back pain and rheumatoid arthrit is: Predieting pain and disability from cognitive variables. Journal of Behavioral Medicine, 11, 251–265.

    Article  PubMed  Google Scholar 

  • Frettlöh, J., Jäkle, C., Kröner-Herwig, B., Basler, H. D., Franz, C., Pelers, H., Rehfisch, H. P., & Seemann, H. (1993). Weisen chronische Kopf-und Rückenschmcrzpatienten spezifische Ebenen der Beeinträchtigung auf? [Is disability syndrome-specific in headache and back pain patients?]. Verhallenstherapie, 3(Suppl. 1),47.

    Google Scholar 

  • Geisser, M. E., Robinson, M. E., & Henson, C. D. (1994). The Coping Strategies Questionnaire and chronic pain adjustment: A conceptual and empirical reanalysis. The Clinical Journal of Pain. 10, 98–106.

    Article  PubMed  Google Scholar 

  • Hasenbring, M., Marienfeld, G., Ahrens, S., & Soyka, D. (1990). Chronifizierende Faktoren bei Paticnten mit Schmerzen durch einen lumbalen Bandscheibenvorfall [Factors of chronification in patients with lumbar disc profusion]. Der Schmerz, 4, 138–150.

    Article  PubMed  Google Scholar 

  • Haythornthwaite, J. A., Sieher, W. J., & Kerns, R. D. (1991). Depression and the chronic pain experience. Pain, 46(2). 177–184.

    Article  PubMed  Google Scholar 

  • Hill, A. (1993). The use of pain coping strategics by patients with phantorn limb pain. Pain. 55, 347–353

    Article  PubMed  Google Scholar 

  • Jensen, M. P., & Karoly, P. (1992) Pain specific beliefs, perceived symptom severity, and adjustment to chronic pain. The Clinical Journal of Pain, 8, 123–130.

    Article  PubMed  Google Scholar 

  • Jensen, M. P., Turner, I. A., Romano, J. M., & Karoly, P. (1991). Coping wilh chronic pain: A critical review of the literature. Pain, 47, 249–283

    Article  PubMed  Google Scholar 

  • Keefe, R. J., Crisson, J., Urban, B. J., & Williams, D. A. (1990), Analyzing chronic back pain: The relative contribution of pain coping strategies. Pain. 40. 293–301

    Article  PubMed  Google Scholar 

  • Keela, A., Mobily, P. R., & Smith, C. (1993). Depression and the experience of chronic hack pain: A study of related variables and age differences. The Clinical Journal of Pain. 9, 104–114

    Article  Google Scholar 

  • Kerns, R. D., & Haythornthwaite, J. A. (1988). Depression among chronic pain patients: Cognitive-behavioral analysis and effect on rehabilitation. Journal of Consulting and Clinical Psychology, 56, 870–876.

    Article  PubMed  Google Scholar 

  • Kerns, R. D., Turk, D. C., & Rudy, T. E. (1985). The West Haven-Yale Multidimensional Pain Inventory (WHYMPI). Pain, 23. 345–356.

    Article  PubMed  Google Scholar 

  • Magni, G., Moreschi, C., Rigatti-Luchini, S., & Merskey, H. (1994). Prospective study of the relationship between depressive symptoms and chronic musculoskeletal pain Pain 56 289–297

    Article  PubMed  Google Scholar 

  • Main, C. J., & Wajdell, G. (1991) A comparison of cognitive measures in low back pain Statistical structure and clinical validity at initial assessment. Pain, 46. 287–298.

    Article  PubMed  Google Scholar 

  • McCracken, L. M., & Gross, R. T. (1993). Does anxiety affect coping with chronic pain? The Clinical Journal of Pain. 9, 253–259.

    Article  PubMed  Google Scholar 

  • Peters, K., & Seemann, H. (in press). Der Heidelberger Coping Fragebogen [The Heidelberg coping inventory).

  • Reesor, K. A., & Craig, K. D. (1988). Medically incongtuent chronic back pain: Physical limitations, suffering, and ineffective coping. Pain, 32, 35–46.

    Article  PubMed  Google Scholar 

  • Rosenstiel, A. K., & Keefe, F. J. (1983). The use of coping strategies in chronic low back pain patients: Relationship to patient characteristics and current adjustment Pain 17 33–44

    Article  PubMed  Google Scholar 

  • Seemann, H. (1993) Krebsschinerz Coping und Kommunikation [Pain in the oncological patient Coping and communication]. Der Schmerz. 7, 322–333.

    Article  PubMed  Google Scholar 

  • Smith, T. W., Peck, J. R., Milano, R, V., & Ward, J. R. (1988). Cognitive distortion in rheumatoid arthritis: relation to depression and disability. Journal of Consulting and Clinical Psychology. 56. 412–416.

    Article  PubMed  Google Scholar 

  • Spinhoven, P., Ter Kuile, M. M., & Linssen, A. C. G. (1989). Pain coping strategies in a Dutch population of chronic low back pain patients. Pain. 37. 77–84.

    Article  PubMed  Google Scholar 

  • Sullivan, M. J. L., & Deon, J. L. (1990). Relation between catastrophizing and depression in chronic pain patients. Journal of Abnormal Psychology. 99, 260–263.

    Article  PubMed  Google Scholar 

  • Turk, D. C., & Rudy, T. E. (1986), Assessment of cognitive factors in chronic pain: A worthwhile enterprise. Journal of Consulting and Clinical Psychology. 54. 760–768.

    Article  PubMed  Google Scholar 

  • Turk, D. C., & Rudy, T. E. (1992). Cognitive factors and persistent pain: a glimpse into Pandora’s box. Cognitive Therapy and Research. 16. 99–122.

    Article  Google Scholar 

  • Turk, D. C., Rudy, T. E., & Stieg, R. L. (1988). The disability determination dilemma: Toward a multiaxial solution. Pain. 34, 217–230.

    Article  PubMed  Google Scholar 

  • Turner, J. A., & Clancy, S. (1986). Strategies for coping with chronic low back pain: Relationship to pain disability. Pain, 24. 355–364.

    Article  PubMed  Google Scholar 

  • von Zerssen, D. (1975). Depressivitäts-Skala (The depression scale]. Weinheim. Germany. Beltz Testgesellschaft.

    Google Scholar 

  • Waddell, G., Newton, M., & Henderson, W. I. (1990). Pain and disability. Pain. Suppl, 5, 498.

  • Waddell, G., Newton, M., Henderson, I., Sommerville, D., & Main, C. J. (1993). A fear-avoidance beliefs questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain, 52. 157–168.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

This study was supported by German Ministry of Research and Technology Grant FKZ 07015089.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kröner-Herwig, B., Jäkle, C., Frettlöh, J. et al. Predicting subjective disability in chronic pain patients. Int. J. Behav. Med. 3, 30–41 (1996). https://doi.org/10.1207/s15327558ijbm0301_3

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1207/s15327558ijbm0301_3

Key words

Navigation