Perceived and functional disability in adults with chronic pain: what accounts for discrepancies?

<p>Disability among patients with chronic pain can be assessed functionally (behaviorally) or subjectively (self-report). However, discrepancies--including low or zero correlations--between these methods are commonly reported. Research suggests that subjective disability may be more influenced by psychosocial factors than disability measured during functional tasks, leading to under/over reporting, but further investigation is needed. This study sought to identify correlates of discrepancies between subjective and functional disability in two samples of patients with chronic pain.</p> <p>Retrospective data was compiled from clinical records of 389 patients evaluated at a university multidisciplinary chronic spinal pain treatment program (52.7% men; 88.9% White, 9.8% Black; spinal pain duration M = 53.54 months; 74.2% reported low back pain; 18.1% did not complete high school, 30.9% completed high school, 36.6% attended some college or vocational training, and 14.1% had a college degree or higher).</p> <p>A sample of 174 adults with rheumatoid arthritis (RA) was recruited from rheumatology clinics (84% women; 55% White, 44% Black, 1% Hispanic; age M = 54.6 years; education M = 13.5 yrs; RA duration M = 11.2 yrs). </p> <p>In each sample markers of psychosocial adjustment (e.g., depression, pain, coping, disability status), subjective disability, and functional disability were assessed. Subjective and functional disability measures were standardized, and a discrepancy score calculated (functional - subjective).</p> <p>Results identified a salubrious pattern of disability discrepancy (subjective < functional), which was associated with less pain, better social functioning, more adaptive coping, and less dysfunctional coping in the chronic spinal pain sample (small to medium effect size, p < .05). The salubrious discrepancy pattern was inversely associated with disability compensation, depression, negative affect, pain, and dysfunctional coping in the RA sample (small effect size, p < .05). Kinesiophobia, religion, and positive affect were not associated with the discrepancy score. The discrepancy pattern where subjective > functional was not associated with any markers of healthy adjustment.</p> <p>Overall, markers of better psychosocial adjustment were modestly associated with the salubrious pattern of functional > subjective disability, whereas poor adjustment was associated with the reverse discrepancy pattern. Theoretical and clinical implications of these findings are discussed.</p>

Name thesis:degree_name

Ph.D.

Level thesis:degree_level

Open Access Dissertation

Discipline thesis:degree_discipline

Psychology

Year dc:date.available

2012

Author dc:creator

• Nevedal, Dana Catharine

Contributors dc:contributor

• Mark A. Lumley

• Disability, Discrepancy, Functional Capacity, Pain, Rheumatoid Arthritis, Spine
• Medicine and Health Sciences
• Psychology

Repository record dc:identifier

https://digitalcommons.wayne.edu/oa_dissertations/553

OAI identifier oai:identifier

oai:digitalcommons.wayne.edu:oa_dissertations-1552