PERCEPTION OF TRAUMATIC ONSET, COMPENSATION STATUS, AND PHYSICAL FINDINGS - IMPACT ON PAIN SEVERITY, EMOTIONAL DISTRESS, AND DISABILITY IN CHRONIC PAIN PATIENTS

The primary purposes of the present study were to investigate the role s of physical findings, financial compensation, and types of pain onse t (i.e., trauma vs. insidious onset) on adaptation by chronic pain pat ients. Comparisons between patients who were receiving or seeking comp ensation and those who were not revealed that, despite comparable degr ees of physical findings, the compensation status was associated with reports of (a) more severe pain, (b) greater disability, (c) higher le vels of emotional distress and (d) greater life interference. The comp ensation status of 74% of the patients was correctly classified by com bination of pain severity, perceived disability, and life interference . Objective indices of physical findings did not significantly improve classification accuracy. In order to eliminate the possible confound of compensation, analyses of the relationship between the types of ons et and chronic pain were conducted only for a subset of patients who w ere not receiving or actively seeking compensation. The results indica ted that the patients who attributed their pain To a specific trauma r eported significantly higher levels of emotional distress, life interf erence and higher levels of pain severity than did the patients who in dicated that their pain had an insidious or spontaneous onset, regardl ess of the extent of objective physical findings.