Psychological impairments, disabilities, and handicaps: a pilot study of psychological assessment of functioning in chronic pain patients

Abstract
This study addresses the psychological assessment of functioning in chronic pain patients. First, a model of functional assessment is proposed, which is based on the biopsychosocial view of chronic disease (Engel) and on the consequences of diseases (WHO). Second, a set of psychological criteria for impairments, disabilities, and handicaps, described by WHO as the consequences of diseases, are determined. Third, the psychological criteria selected are operationalized and the utility of the psychological assessment instruments tested in a clinical rehabilitation study. The results indicate that prediction of post-treatment functioning in the rehabilitation patient, by psychological procedures, may improve if the concept of functioning is determined as three sub-areas of impairments, disabilities, and handicaps.