BACKGROUND: Locus of control (LOC) is related to the impact of headaches and chronic pain; however, literature evidence regarding LOC is not always consistent. Several authors consider this to be due, in part, to the separate interpretation of LOC factors, during which the interaction among them is ignored. In 1982, Wallston and Wallston proposed eight possible LOC health patterns depending on whether the individual scored high or low in each of three dimensions. OBJECTIVE: To identify these LOC patterns in patients with headaches and chronic pain, and to validate them in terms of their association with a selection of the main pain indicators. METHODS: A total of 228 individuals were recruited at three public centres in Seville, Spain. Participants completed a semistructured clinical interview and several questionnaires assessing psychological variables related to pain. The main statistical analyses used were two-step cluster analysis and ANCOVA. RESULTS: The six-cluster solution was optimal. The patterns observed coincided with: the believer in control; the yea-sayer; the pure chance; the pure internal; the pure professional; and the nay-sayer clusters. The double external or type VI clusters were not observed. Clusters could be classified from the best to the worst adjustment to chronic pain. CONCLUSIONS: These results support the empirical validity of the theoretical model of LOC patterns proposed in 1982 by Wallston and Wallston among a chronic pain population. The analysis of patterns provides more accurate information regarding the adjustment to pain compared with analysis of the LOC factors separately.
BACKGROUND: Locus of control (LOC) is related to the impact of headaches and chronic pain; however, literature evidence regarding LOC is not always consistent. Several authors consider this to be due, in part, to the separate interpretation of LOC factors, during which the interaction among them is ignored. In 1982, Wallston and Wallston proposed eight possible LOC health patterns depending on whether the individual scored high or low in each of three dimensions. OBJECTIVE: To identify these LOC patterns in patients with headaches and chronic pain, and to validate them in terms of their association with a selection of the main pain indicators. METHODS: A total of 228 individuals were recruited at three public centres in Seville, Spain. Participants completed a semistructured clinical interview and several questionnaires assessing psychological variables related to pain. The main statistical analyses used were two-step cluster analysis and ANCOVA. RESULTS: The six-cluster solution was optimal. The patterns observed coincided with: the believer in control; the yea-sayer; the pure chance; the pure internal; the pure professional; and the nay-sayer clusters. The double external or type VI clusters were not observed. Clusters could be classified from the best to the worst adjustment to chronic pain. CONCLUSIONS: These results support the empirical validity of the theoretical model of LOC patterns proposed in 1982 by Wallston and Wallston among a chronic pain population. The analysis of patterns provides more accurate information regarding the adjustment to pain compared with analysis of the LOC factors separately.
Authors: J P Mackenbach; G J Borsboom; W J Nusselder; C W Looman; C T Schrijvers Journal: J Epidemiol Community Health Date: 2001-09 Impact factor: 3.710