Biopsychosocial functioning and pain self-efficacy in chronic low back pain patients

The aim of this study was to examine the relationship between biopsychosocial functioning and pain severity and to evaluate whether pain self-efficacy (PSE) mediates this relationship. This study used archival data from a multidisciplinary pain management program. Participants were 99 individuals (69% female) with chronic low back pain who completed measures of biological, psychological, and social functioning, pain severity, and PSE at admission. They ranged in age from 18 to 72 yr (mean = 42.6, standard deviation = 12.1). Structural equation modeling and bootstrapping techniques were used to test the significance of the mediated model. As we predicted, lower biological functioning (beta = -0.011; 95% confidence interval [CI] = -0.019 to -0.004, p = 0.002) and social functioning (beta = -0.009; 95% CI = -0.016 to -0.003, p = 0.007) were found to significantly predict higher pain severity, and lower social functioning was found to significantly predict lower PSE (beta = 0.196; 95% CI = -0.130 to 0.273, p = 0.002). PSE did not mediate the relationship between biopsychosocial functioning and pain severity, and psychological functioning did not significantly predict pain severity or PSE. These findings suggest that social functioning is an important factor in predicting outcomes and has a number of treatment implications.