COGNITIVE-BEHAVIORAL CLASSIFICATIONS OF CHRONIC PAIN - REPLICATION AND EXTENSION OF EMPIRICALLY DERIVED PATIENT PROFILES

Many attempts have been made to classify patients with chronic pain in order to make sense of a very complex problem and to direct patients towards appropriate treatments for their condition. Unfortunately, the se efforts have not been empirically based and have demonstrated limit ed clinical use. Predominant emphasis has been placed on either biomed ical or psychopathological elements of the chronic pain experience wit h little integration of cognitive-behavioral factors. Turk and Rudy (1 988) introduced an empirically derived pain patient taxonomy based on analyses of the Multidimensional Pain Inventory (MPI). The primary pur pose of the present study was to replicate this classification system by using different measures for similar constructs in different groups of chronic pain patients. Items designed to measure 4 constructs (act ivity interference, emotional distress, pain intensity, and perceived support) were collected from 1594 pain patients evaluated at two separ ate pain treatment facilities. Confirmatory factor analytic results in dicated high reliability of the items in measuring these 4 constructs. Replicated clustering techniques demonstrated the robustness of 3 pat ient profiles across the patient samples. The 3 clusters corresponded remarkably well to the groups initially labeled by Turk and Rudy (1988 ) as Dysfunctional, Interpersonally Distressed and Adaptive Copers. Ex ternal validation of the classification system supported replication o f the 3 groups and offered further interpretational clarity to the pat ient profiles. Strong evidence was found for a taxonomy of 3 chronic p ain patient groups. Implication for predicting treatment outcome and f or future research are discussed.