Pain beliefs: assessment and utility.

When pain becomes persistent, patients may abandon previously held cultural or personal beliefs about pain to form new pain beliefs that are more consistent with their persistent pain experience. The Pain Beliefs and Perceptions Inventory (PBPI) is an instrument to assess these new beliefs. This paper presents 4 studies examining the utility of the PBPI. Two studies are factor analytic and support recent literature identifying 4 belief factors associated with this instrument. The third and fourth studies used a new scoring method for the PBPI creating 4 scales: Mystery, Self-blame, Pain Permanence, and Pain Constancy. These scales were then correlated with important pain indices such as measures of pain quality, psychological states (i.e., depression and anxiety), personality traits, physical functioning, and coping strategies. Each belief appears to have a unique association with the pain indices thus supporting the rescoring of this instrument with 4 scales. Belief in pain constancy is associated with greater pain self-report, permanence is associated with anxiety, mystery is associated with greatest overall distress, and self-blame is associated with depressive symptoms. An appendix is included that provides clinical norms for the use of the PBPI and a revised scoring key.