Patterns of psychological disturbance and pain report in patients with low back pain (original) (raw)
Related papers
Pain, 1981
The principal dimensions of the pain experience of 102 patients with chronic low back pain were studied and components of the pain experience were compared to pretreatment measures of emotional disturbance. Responses on the McGill Pain Questionnaire (MPQ) were factor analyzed revealing dimensions of the pain experience that seemed to represent sensory, affective, and evaluative aspects. Patients with high scores on the MMPI hypochondriasis scale portrayed their pain as more intense and as high in terms of affective and evaluative descriptors on the MPQ. Other MMPI scales reflecting emotional disturbance (depression, hysteria) were also associated with a more intense description of pain and higher scores on an affective descriptor dimension. The evaluative descriptive dimension was highly related to the overall intensity of the pain experience. Only the affective dimension was related to emotional disturbance separately from the effects of intensity alone.
Pain, 1979
Patients with undiagnosable low back pain have been observed to differ from patients with proven low back paLu in their clinical description of pain and in their psychological status. More variable and diffuse pain qualities are emphasized in their clinical reports and more psychological disturbance characterizes them as a group, suggesting an association between pain expression and psychological disturbance. One hundred and two patients with low back pain were administered a standardized pain questionnaire to determine more systematically the association beween pain expression and psychological disturbance in patients with and without demonstrable organic disease. Patients with psychological disturbance differed significantly from patients without psychological disturbance in the following ways. They used more words in their description of pain, distributed these words over more pain factors, and endorsed significantly more pain of the affective and skin pressure variety. The results underscore previous clinical impressions and suggest that patients without either organic or psychological findings may be cases of undiagnosed organic disease.
Comparison of three measures for detecting psychological disturbance in patients with low back pain
PAIN, 1982
The MMPI Low Back Scale, the 'Conversion V' MMPI profile and the Back Pain Classification Scale were compared for accuracy in detecting psychological disturbance in a sample of 91 patients with low back pain. These patients were classified as to the presence or absence of organic findings and psychological disturbance on the basis of objective and independent evaluations. Hit rates of 37.4%, 64.5~ and 78.0~ were produced by the 3 measures, respectively. The Back Pain Classification Scale was the most accurate measure, and the only scale to exceed base rate. The implications of these findings for clinical practice are discussed.
Evaluation of the Psychological Status in Chronic Low Back Pain: Comparison with General Population
Pain Physician, 2002
Multiple studies have documented a strong association between chronic low back pain and psychopathology including personality disorders, depressive disorders, anxiety, and somatoform disorders along with non-specific issues such as emotion, anger and drug dependency. However, depression, anxiety and somatization appear to be crucial. There are no controlled trials in interventional pain management settings. This study was designed to evaluate 40 individuals without pain or psychotherapeutic drug therapy, Group I, control group; and Group II, chronic low back pain group with 40 chronic low back pain patients. All the participants were tested utilizing Pain Patient Profile (P3). Significant differences were found among various clinical syndromes with generalized anxiety disorder, somatoform disorder, and depression, with 0% vs 20%, 0% vs 20%, and 5% vs 30% in Group I and Group II consecutively. This evaluation showed that clinical syndromes were seen in a greater proportion of patients with chronic low back pain emphasizing the importance of evaluation of the patients for generalized anxiety disorder, somatoform disorder, and for depression.
Journal of Behavioral Medicine, 1983
Previous research involving cluster analysis of Minnesota Multiphasic Personality Inventory (MMPI) profiles among persons with chronic low back pain has suggested the existence o f four distinct profile clusters. The present study had two goals: (1) to replicate the previous finding independently and (2) to investigate the relationship of the profiles to the subjects" selfreported pain history and response to treatment. Subjects were 92 patients in a multimodal inpatient low back-pain treatment program. A cluster analysis of the MMPI profiles was performed and the resultant clusters were compared in terms of histories and treatment outcome. The four clusters were successfully replicated for the total sample and for males and females separately. The profiles were significantly related to subjects" pain histories, but only one outcome difference was found. It was inferred that the MMPI is of value in understanding patients'pain coping behaviors but that further research is needed to explore the utility of the MMPI in understanding their response to treatment.
Acute and Chronic Pain: Pain Dimensions and Psychological Status
Journal of Clinical Psychology, 1989
One hundred and ten outpatients with either acute or chronic low-back pain completed the McGill Pain Questionnaire, Beck Depression Inventory, State-Trait Anxiety Inventory, and Life Experiences Survey. Acutes and chronics did not differ on dimensions of pain, but significant correlations between pain dimensions and depression and state anxiety were found for chronics. Both groups showed elevated state anxiety; chronics also evidenced mild depression. Combined scores on depression, anxiety, and negative life change predicted sensory and affective pain for the pooled sample. These results confirm the role of psychological variables in the experience of clinical pain and underscore the highly affective nature of chronic pain.
The detection of psychological disturbance in patients with low back pain
Journal of Psychosomatic Research, 1979
The feasibility of developing a pain scale for detecting psychological disturbance in patients with low back pain was investigated in two studies. In the first study, stepwise discriminant analysis was used to identify the best combination of pain terms that would discriminate the functional group from the organic group. Thirteen pain variables were identified which correctly identified 93.6 % of the cases of low back pain. These pain terms were used to categorize 159 new cases in the second. Cross-validation shrinkage was only 10.6%. One hundred and thirty-two out of 159 cases in the new sample were correctly classified. The advantages of this pain scale over existing methods are discussed, along with implications for clinical orthopedic practice.
Journal of Musculoskeletal Pain, 2003
Objective: To evaluate psychological dimensions of pain and to identify any correlation between pain duration and psychological symptomatology in chronic pain patients. Methods: A shortened version of the Minnesota Multiphasic Personality Inventory was administered to 45 patients with fibromyalgia syndrome [FMS], 40 patients with chronic low back pain [CLBP], 20 patients with rheumatoid arthritis [RA] and the results were compared with data from 30 demographically-matched healthy normal controls [HNC].
Journal of Personality Assessment, 2000
This study investigated the utility of the MMPI-2-based Personality Psychopathology Five (PSY-5) scales (Harkness, McNulty, & Ben-Porath, 1995) in the outcome prediction of behaviorally oriented chronic-pain treatment. The PSY-5 is a dimensional descriptive system for personality and its disorders. The sample consisted of 120 consecutive chronic-back-pain patients who followed a 4-week multimodal treatment program aimed at achieving a normal pattern of functioning, including return to regular work. The psychometric properties of the PSY-5 scales (Aggressiveness, Psychoticism, Constraint, Negative Emotionality/Neuroticism, and Positive Emotionality/Extraversion) were highly similar to the data reported by Harkness et al. (1995) and also corresponded to the characteristics of chronic-pain patients. The results of the hierarchical regression analyses provided support for the utility of the PSY-5 Positive Emotionality/Extraversion scale for the prediction of emotionally oriented outcome. We conclude that the PSY-5 model of personality psychopathology provides a solid basis for the more systematic study of the complex relation between personality characteristics and multidimensional treatment. In this age of short-term treatment and managed care, psychological assessment has become quite important. Explicit, integrated, and empirically based models of treatment selection have also become critical (Norcross & Beutler, 1997). Treatment is more likely to succeed when a clinician has clear insight into the problems