ASSESSING THE STAGES OF PAIN PROCESSING - A MULTIVARIATE ANALYTICAL APPROACH

A four-stage model of pain processing was proposed, consisting of pain sensation intensity, pain unpleasantness (stage 1 affect), suffering (stage 2 affect), and pain behavior. We studied 506 chronic pain patie nts (230 male and 276 female) using a multivariate statistical techniq ue (LISREL) in order to demonstrate the structural relationship among multiple indicators of pain processing; and to characterize these stag es in terms of their interactions. A strong relationship was revealed between the majority of the underlying indicators of each pain process ing stage. A linear stage sequence best fitted the relationship betwee n the four stages. Successive stages did not have recursive effects on earlier pain components, A confirmatory LISREL analysis was conducted with an additional sample of 502 chronic pain patients. In this repli cation analysis the structural equation model consisted of pain intens ity, unpleasantness (stage 1 affect), emotional suffering (stage 2 aff ect), and pain behavior. This study extends the validation of these pa in dimensions, as well as the validity of the measure(s) of each separ ate stage.