Abstract
Four hundred fifty-three chronic pain patients completed a Symptom Checklist 90 (SCL-90) and a comprehensive pain evaluation questionnaire. All patients were evaluated by a physician and rated on degree of pain pathology and pain behavior. The SCL-90 data were analyzed using two clustering procedures and replicated over two similar samples. Three distinct profiles emerged and represented high, medium, and low scores on the SCL-90. No differences were found between subgroups on demographic characteristics, compensation status, pain duration, or pain ratings. Patients in the high-profile subgroup showed the most emotional distress, reported that their pain interfered the most with all activities, and were most often judged to have high pain behavior. Little evidence was found to support a “denial” profile, as previously predicted. Further support was found for using the SCL-90 in assessing chronic pain patients.
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References
Armentrout, D. P., Moore, J. E., Parker, J. C., Hewett, J. E., and Feltz, C. (1982). Painpatient MMPI subgroups: The psychological dimensions of pain.J. Behav. Med. 5: 201–211.
Blashfield, R. K. (1980). Propositions regarding the use of cluster analysis in clinical research.J. Consult. Clin. Psychol. 48: 456–459.
Bradley, L. A., and Van der Heide, L. H. (1984). Pain-related correlates of MMPI profile sub-groups among back pain patients.Health Psychol. 3: 157–174.
Bradley, L. A., Prokop, C. K., Margolis, R., and Gentry, W. D. (1978). Multivariate analyses of the MMPI profiles of low back pain patients.J. Behav. Med. 1: 253–272.
Brena, S. F., Koch, D. L., and Moss, R. M. (1976). Reliability of the “pain estimate” model.Anesth. Rev. 3: 28–29.
Cyr, J. J., McKenna-Foley, J. M., and Peacock, E. (1985). Factor structure of the SCL-90-R: Is there one?J. Personal. Assess. 49: 571–578.
DeGood, D. E., Buckelew, S. P., and Tait, R. C. (1985). Cognitive-somatic anxiety response patterning in chronic pain patients and nonpatients.J. Consult. Clin. Psychol. 53: 137–138.
Derogatis, L. (1977).SCL-90-R (Revised Version) Administration, Scoring and Procedure Manual, Johns Hopkins University School of Medicine, Baltimore, Md.
Engelman, L., and Hartigan, J. A. (1981). K-Means clustering. In Dixon, W. J. (ed.)BMDP Statistical Software. University of California, Berkeley.
Everitt, B. (1980).Cluster Analysis (2nd ed.), Halstead-Wiley, New York.
Johnson, S. (1967). Hierarchical clustering schemes.Psychometrika 32: 241–254.
Leavitt, F. (1982). Comparisons of three measures for detecting psychological disturbance in patients with low back pain.Pain 13: 299–305.
Leavitt, F. (1985). The value of the MMPI conversion “V” in the assessment of psychogenic pain.J. Psychosom. Res. 29: 125–131.
Love, A. W., and Peck, C. L. (1987). The MMPI and psychological factors in chronic low back pain: A review.Pain 28: 1–12.
McGill, J. C., Lawlis, G. F., Selby, D., Mooney, V., and McCoy, C. E. (1983). The relationship of Minnesota Multiphasic Personality Inventory (MMPI) profile clusters to pain patients.J. Behav. Med. 6: 77–92.
Melzack, R. (1975). The McGill Pain Questionnaire: Major properties and scoring methods.Pain 1: 277–299.
Morey, L. C., and Agresti, A. (1984). The measurement of classification agreement: An adjustment to the Rand statistic for chance agreement.Educ. Psychol. Measure. 44: 33–37.
Morey, L. C., Blashfield, R. K., and Skinner, H. A. (1983). A comparison of cluster analysis techniques within a sequential validation framework.Multivar. Behav. Res. 18: 309–329.
Prokop, C. K., Bradley, L. A., Margolis, R., and Gentry, W. D. (1980). Multivariant analyses of the MMPI profiles of multiple pain patients.J. Personal. Assess. 44: 246–252.
Schwartz, D. P., and DeGood, D. E. (1983). An approach to the psychosocial assessment of the chronic pain patient.Curr. Concepts Pain 1: 3–11.
Shutty, M. S., and DeGood, D. E. (1987). Cluster analyses of responses of low-back pain patients to the SCL-90: Comparison of empirical versus rationally derived subscales.Rehab. Psychol. 32: 133–144.
Shutty, M. S., DeGood, D. E., and Schwartz, D. P. (1986). Psychological dimensions of distress in chronic pain patients: A factor analytic study of Symptom Checklist-90 responses.J. Consult. Clin. Psychol. 54: 836–842.
Snyder, D. K., and Power, D. G. (1981). Empirical descriptors of unelevated MMPI profiles among chronic pain patients: A typological approachJ. Clin. Psychol. 37: 602–607.
Sternbach, R. (1974).Pain Patients: Traits and Treatments, Academic Press, New York.
Tarbox, A. R., and Conners, G. J. (1986). Stress management and the treatment of chronic pain syndrome. In Russell, M. (ed.),Stress Management for Chronic Disease, Pergamon Press, New York.
Timmermans, G., and Sternbach, R. (1976). Human chronic pain and personality: A canonical correlation analysis. In Bonica J. J., and Albe-Fessard, D. G. (eds.),Advances in Pain Research and Therapy, Raven Press, New York.
Ward, J. H. (1963). Hierarchical grouping to optimize an objective function.J. Am. Stat. Assoc. 58: 236–244.
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Jamison, R.N., Rock, D.L. & Parris, W.C.V. Empirically derived Symptom Checklist 90 subgroups of chronic pain patients: A cluster analysis. J Behav Med 11, 147–158 (1988). https://doi.org/10.1007/BF00848262
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DOI: https://doi.org/10.1007/BF00848262