Relationship of pain-specific beliefs to chronic pain adjustment.

Cognitive-behavioral models suggest that pain patients' beliefs about their pain play a critical role in their adjustment. This study sought to replicate and extend previous research that has examined the relationship between pain-specific beliefs and adjustment to chronic pain. Two hundred forty-one chronic pain patients evaluated for possible admission to an inpatient pain treatment program completed the Sickness Impact Profile (SIP) and the Survey of Pain Attitudes (SOPA), as well as measures of pain, medical services utilization and demographic characteristics. The results indicated that the beliefs that emotions affect pain, that others should be solicitous when the patient experiences pain, and (for subjects reporting low and medium levels of pain severity) that one is disabled by pain were associated positively with psychosocial dysfunction. The beliefs that one is disabled and that activity should be avoided because pain signifies damage were associated positively with physical disability. None of the beliefs assessed was significantly associated with number of physician visits in the previous 3 months, although belief in the appropriateness of medications for managing chronic pain was associated positively with pain-related emergency room visits. The results support a cognitive-behavioral model of chronic pain adjustment and suggest specific pain beliefs to target in treatment studies examining causal relationships between beliefs and adjustment.