ATTITUDE PROFILES AND CLINICAL STATUS IN PATIENTS WITH CHRONIC PAIN

While attitudes toward pain have been identified as important mediator s of patient adjustment to pain and response to treatment, research to date has focused on single attitude scales. The present study examine d relations between attitude profiles and a set of variables reflectin g clinical status in 395 chronic pain patients seen through a comprehe nsive pain center. A clustering procedure identified four distinct pat ient clusters, two of which displayed self-reliant attitude sets and t wo of which displayed medically oriented attitudes. Within each of the latter groupings, one patient cluster demonstrated attitudes that ref lected little emotionality associated with pain, while the attitudes o f the other cluster reflected higher levels of emotional involvement. Clusters differed on clinical status variables, with the self-reliant/ emotional and self-reliant/low emotional groups reporting less severe pain, less disability, less emotional distress, and a greater likeliho od of employment than the medically oriented groups. The medically ori ented groups differed in terms of level of distress, with the more dis tressed group reporting pain of a greater duration. The results sugges t that patients can be classified into attitudes profiles that are ass ociated with meaningful differences in clinical status. Further resear ch should investigate attitudes among more functional patients with ch ronic pain, especially as they affect the evolution of chronic pain sy ndromes. (C) 1998 International Association for the Study of Pain. Pub lished by Elsevier Science B.V.