When pain becomes persistent, patients may abandon previously held cul
tural or personal beliefs about pain to form new paid beliefs that are
more consistent with their persistent pain experience. The Pain Belie
fs and Perceptions Inventory (PBPI) is an instrument to assess these n
ew beliefs. This paper presents 4 studies examining the utility of the
PBPI. Two studies are factor analytic and support recent literature i
dentifying 4 belief factors associated with this instrument. The third
and fourth studies used a new scoring method for the PBPI creating 4
scales: Mystery, Self-blame, Pain Permanence, and Pain Constancy. Thes
e scales were then correlated with important pain indices such as meas
ures of pain quality, psychological states (i.e., depression and anxie
ty), personality traits, physical functioning, and coping strategies.
Each belief appears to have a unique association with the pain indices
thus supporting the rescoring of this instrument with 4 scales. Belie
f in pain constancy is associated with greater pain self-report, perma
nence is associated with anxiety, mystery is associated with greatest
overall distress, and self-blame is associated with depressive symptom
s. An appendix is included that provides clinical norms for the use of
the PBPI and a revised scoring key.