Participant's perception of negative cognition in low back pain: a pilot study

It has been theorized that low back pain contributes to the development of negative cognition (negative thinking) which may predispose a person towards chronicity. The objective of this paper is to examine the role of negative cognition in non-depressed participants who have previously experienced low back pain.

Ten students enrolled in a course at the University of Kansas were involved in a 4 week educational project. The participants completed self-rated assessments of depression using the 21 item Beck Depression Inventory (BDI-21) and the visual analogue pain scale (VAS). The study was broken into 3 phases over 4 weeks. Phase 1 focused on the VAS and the BDI-21 along with questions pertaining to low back pain. Phase 2 included 2 questions with 1 of the questions focusing on common negative distortions. Phase 3 focused on 11 clinical-type questions relating to awareness of negative thinking and chronic low back pain.

Phase 1 showed that 7 of the students had a history of chronic low back pain while 8 students believed they had negative thoughts when low back pain occurred. Conversely, only 1 student had experienced negative thoughts prior to a low back pain episode. The initial BDI-21 scores demonstrated a mean score of 5.5 with a mean VAS of 5.75. After students were exposed to the idea that they may have negative cognition processes (phase 2), 4 students indicated that they noticed themselves thinking negatively and attempted to alter such processes. Phase 3 results indicated that 4 of the students did attempt to change negative thinking after being made aware that negative thinking could be present.

The results of this study showed that a majority of participants believed that a person's negative thoughts can impair a person toward activity yet none of the participants believed that such had occurred to them. Further research in the area of negative cognition and chronic low back pain is needed.