Psychosocial subgroups, coping, and chronic low-back pain

The purpose of this study was to compare psychosocial subgroups in terms of pain coping strategies, pain severity, physical impairment, pain behavior, affective distress, and response to pain management treatment. The Multidi mensional Pain Inventory (MPI) was used to classify 67 chronic low-back pai n (CLBP) patients into the following psychosocial subgroups: Dysfunctional, Interpersonally Distressed, Adaptive Coping, and Anomalous. These MPI subg roups were compared on the Pain Behavior Checklist, Behavioral Observation Measure of Pain Behavior, Revised Coping Strategies Questionnaire, and Chro nic Disease Index. The Dysfunctional subgroup reported significantly more p ain behavior, disability, affective distress, and catastrophizing than eith er the Interpersonally Distressed subgroup or Adaptive Copers, but were not significantly different on measures of adaptive coping strategies. The per centage of dropouts from treatment was significantly less among Adaptive Co pers (11%) than among the Dysfunctional (33%) or Interpersonally Distressed (47%) subgroups. Differences in affective distress found among the MPI sub groups at baseline were not evident at the posttreatment assessment. The pr esent findings support the use of MPI psychosocial subgroup analysis to enh ance our understanding of differential response to chronic pain and pain ma nagement intervention.