WADDELL SIGNS - DISTRIBUTIONAL PROPERTIES AND CORRELATES

Objective: To determine what percentage of patients have none of the f ive nonorganic behavioral processes known as Waddell signs, and the re lational pattern between Waddell signs and somatic complaints, disturb ed functional performance, negative treatment attitudes, physical path ology, depression, generalized anxiety, and MMPI-2 validity scales. De sign: Case series survey. Setting: A referral-based multidisciplinary pain center affiliated with a state medical school. Patients: Seventy- five consecutive patients with chronic back pain. Intervention: Medica l evaluation and completion of self-report inventories. Main Outcome M easure: Total number of Waddell signs, physical pathology, and pain in tensity ratings were assessed by a physician during an initial medical evaluation. Degree of disturbed functional performance and psychologi cal symptoms were assessed by self-report measures at the initial eval uation. Results: Sixty-four percent of the patients had no Waddell sig ns. Total number of Waddell signs yielded positive and statistically s ignificant correlations (p less than or equal to .05) with depression, disturbed functional performance, somatic complaints, and pain intens ity ratings. Correlations of slightly smaller and statistically nonsig nificant magnitudes were revealed for Waddell signs with generalized a nxiety, negative treatment attitudes, and physical pathology. Waddell signs were unrelated to age, duration of pain, gender, number of lumba r surgeries, and MMPI-2 validity scales. Conclusions: Taken together, multiple Waddell signs and some of their correlates present various fa ctors that might interfere with optimal response to treatment. (C) 199 8 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.