PREDICTING SUBJECTIVE DISABILITY IN CHRONIC PAIN PATIENTS

Subjective disability is considered as the variable that reflects the impact of chronic pain on a patient's life. This study examines the qu estions of which syndrome or patient characteristics determine subject ive disability and whether there are differences between samples of pa tients with chronic headaches and low back pain. Direct pain variables and depression, pain coping strategies, and pain-related self-stateme nts (including catastrophizing) are introduced into multivariate regre ssion analyses as potential predictors of disability using a sample of 151 pain patients. Disability is not predicted by pain severity in pa tients with headaches or back pain, Psychological variables, especiall y coping strategies, are far more influential. Coping explains more va riance in disability in the headache sample than in the chronic low ba ck pain group, whereas depression is more relevant for the degree of d isability in the back pain sample. In this study, we present a critica l analysis of possible interpretations of our results. We point to an overlap of concepts underlying some of the variables used; this overla p also considerably invalidates conclusions drawn from a multitude of studies done in this field, including the one presented, We strongly a rgue for a conceptual clarification, and consequently for the revision of assessment instruments, before further empirical work in this area is done.