EXPERIENCE OF PAIN IN RHEUMATOID-ARTHRITIS - AN EMPIRICAL-EVALUATION OF THE CONTRIBUTION OF DEVELOPMENTAL PSYCHOSOCIAL STRESS

Using a structured biographical history we evaluated the relationship between aspects of development and reports of pain experience (i.e. in tensity of pain, affective and affective-evaluative dimensions of pain according to the McGill pain questionnaire, and effectiveness of medi cation) in 66 patients with rheumatoid arthritis. It was postulated th at higher loading with regard to developmental stress would have a neg ative influence on reports of pain experience. Multiple regression ana lysis showed that (i) the intensity of pain was significantly correlat ed with the functional stage of the illness, (ii) affective and affect ive evaluative dimensions of pain experience correlated with the inter viewer's scoring of nurture and the patient's relationship with his or her partner, and (iii) the effectiveness of medication was significan tly associated with the partner's understanding of the patient's pain and duration of illness. However, independent variables could explain only part of the variance (i.e. 12% for pain intensity, 17% for affect ive and affective-evaluative dimensions of pain experience and 26% for the effectiveness of medication). These results suggest that the prev iously assumed importance of developmental psychosocial stress as a fa ctor in chronic intractable pain may require careful reassessment.