Attitude profiles and clinical status in patients with chronic pain

While attitudes toward pain have been identified as important mediators of patient adjustment to pain and response to treatment, research to date has focused on single attitude scales. The present study examined relations between attitude profiles and a set of variables reflecting clinical status in 395 chronic pain patients seen through a comprehensive pain center. A clustering procedure identified four distinct patient clusters, two of which displayed self-reliant attitude sets and two of which displayed medically oriented attitudes. Within each of the latter groupings, one patient cluster demonstrated attitudes that reflected little emotionality associated with pain, while the attitudes of the other cluster reflected higher levels of emotional involvement. Clusters differed on clinical status variables, with the self-reliant/emotional and self-reliant/low emotional groups reporting less severe pain, less disability, less emotional distress, and a greater likelihood of employment than the medically oriented groups. The medically oriented groups differed in terms of level of distress, with the more distressed group reporting pain of a greater duration. The results suggest that patients can be classified into attitudes profiles that are associated with meaningful differences in clinical status. Further research should investigate attitudes among more functional patients with chronic pain, especially as they affect the evolution of chronic pain syndromes.