A rating system for use with patient pain drawings

Patients entering treatment for chronic benign pain often are asked to complete drawings indicating the intensity and location of their pain as part of the diagnostic process. While inferences have been made from pain drawings about the relative contributions of physiological and psychological factors to the patient's experience of pain, previous research has provided only equivocal support for this practice. A reliable method for assessing pain drawings is needed both for clinical use and to assess the validity of such interpretations. While a number of systems for using such drawings have been proposed, it is not always clear exactly what aspect of the drawing is being quantified. In this study, 101 patients who presented with chronic pain were asked to complete pain drawings which were than scored for the presence or absence of pain in each of 45 body areas. Scorers achieved a high rate of inter-rater agreement with relatively little training. The body surface scores obtained were shown to correlate highly with the penalty point system developed by Ransford et al., suggesting that extent of pain may account for much of the variance in this system. The results are discussed in relation to the clinical and experimental uses for such a system.