High risk model of threat perception in chronic pain patients: implications for primary care and chronic pain programs.

This study investigated the High Risk Model of Threat Perception (HRMTP) in middle-aged, urban chronic pain patients who had been referred to a secondary pain clinic after failing to respond to standard medical management. Relationships among absorption, social desirability (SD), and negative (e.g., depressive or anxious) affect were studied in 24 male and 73 female patients, (age range 22-88 years). Subjects completed the Tellegen Absorption Scale, the Marlowe-Crowne Social Desirability Scale, the Beck Depression Inventory--Second Edition, and the Beck Anxiety Inventory. The sample was significantly higher in SD and lower in absorption than normative groups. High SD patients endorsed significantly fewer items related to depression than those with low SD, but reported anxious ideation at about the same rate. These findings lend credence to the concept of chronic pain as a transduction of depressive, but not anxious, affect into somatic symptoms.