Pain greater than pain behaviors: the utility and limitations of the pain behavior construct.

A great deal of attention has been given to the importance of learning factors in communications of pain and suffering--pain behaviors. The concept of pain behaviors has served a heuristic function, however, there remain a number of important questions to be answered regarding the assessment and conceptual limitations of the construct. These concerns and questions must be acknowledged if the construct is to be of use in enhancing our understanding of chronic pain syndromes and to be employed in treatment. Current conceptualizations of pain behaviors are examined and methods of assessing pain behaviors are evaluated. The validity and utility of the construct and its limitations are discussed. It is concluded that failure to consider psychosocial, psychophysiological, and medical-physical factors may lead to an inadequate understanding of the patient and results in inappropriate treatment interventions. Suggestions for refined understanding of the scope of the construct are provided.