SCREENING FOR PATIENTS AT RISK OF DEVELOPING CHRONIC INCAPACITY

Formal investigations of psychiatric disorders and long-term personali ty characteristics have been relatively unhelpful in the prediction of future incapacity. Clinical studies of pain patients have led to a ne w range of more specific measurement instruments assessing different a spects of psychological functioning: such as pain behavior distress, b eliefs about pain, and coping strategies. Recent investigations of pat ients with acute back problems have identified a strong relationship b etween levels of distress, dysfunctional coping strategies, and future disability. Measurement instruments specifically validated for occupa tional settings still need to be developed, but preliminary studies su ggest that fear of hurting/harming job stress, and job satisfaction ma y be important factors. A pilot study into occupationally-oriented bac k pain management for the unemployed is reported. Results suggest that such clients may have significantly more rehabilitation potential tha n has previously been believed.