A Comparison of Models Describing Reports of Disability Associated with Chronic Pain

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Abstract
We examined pain-related disability from two perspectives. A disability model, suggesting that disability is a direct consequence of pain, is compared with a symptom perception model emphasizing individual differences in perception and report of physical symptoms. Disability estimates (reported activity interference and employment status) were obtained from a sample of 179 patients with chronic pain. Using multiple regression analyses, we showed that distress, symptom reporting, and pain intensity accounted for comparable levels of variance in reports of activity interference. When we controlled for distress, the frequency of reporting physical symptoms made the largest contribution to prediction of this kind of disability (14%). Neither symptom report or pain intensity was useful in predicting the more objective disability criterion of employment status. Results were interpreted as probable evidence against a disability model of pain-related disability and suggest the relative importance of individual cognitive differences in symptom responsivity.

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