@article {Rabey:2016:0749-8047:1015,
title = "Differing Psychologically Derived Clusters in People With Chronic Low Back Pain are Associated With Different Multidimensional Profiles",
journal = "The Clinical Journal of Pain",
parent_itemid = "infobike://wk/cjpn",
publishercode ="wk",
year = "2016",
volume = "32",
number = "12",
publication date ="2016-12-01T00:00:00",
pages = "1015-1027",
itemtype = "ARTICLE",
issn = "0749-8047",
eissn = "1536-5409",
url = "https://www.ingentaconnect.com/content/wk/cjpn/2016/00000032/00000012/art00001",
doi = "doi:10.1097/AJP.0000000000000363",
keyword = "psychological, chronic low back pain, multidimensional, subgrouping",
author = "Rabey, Martin and Smith, Anne and Beales, Darren and Slater, Helen and OSullivan, Peter",
abstract = "
Objectives:
To explore the existence of subgroups in a cohort with chronic low back pain (n=294) based upon data from multiple psychological questionnaires, and profile subgroups on data from multiple dimensions.
Methods:
Psychological questionnaires considered
as indicator variables entered into latent class analysis included: Depression, Anxiety, Stress scales, Thought Suppression and Behavioural Endurance subscales (Avoidance Endurance questionnaire), Chronic Pain Acceptance Questionnaire (short-form), Pain Catastrophising Scale, Pain Self-Efficacy
Questionnaire, and Fear-Avoidance Beliefs Questionnaire. Multidimensional profiling of derived clusters included: demographics, pain characteristics, pain responses to movement, behaviors associated with pain, body perception, pain sensitivity, and health and lifestyle factors.
Results:
Three
clusters were derived. Cluster 1 (23.5%) was characterized by low Cognitive and Affective Questionnaire scores, with the exception of fear-avoidance beliefs. Cluster 2 (58.8%) was characterized by relatively elevated thought suppression, catastrophizing, and fear-avoidance beliefs, but lower
pain self-efficacy, depression, anxiety, and stress. Cluster 3 (17.7%) had the highest scores across cognitive and affective questionnaires.Cluster 1 reported significantly lower pain intensity and bothersomeness than other clusters. Disability, stressful life events, and low back region
perceptual distortion increased progressively from cluster 1 to cluster 3, whereas mindfulness progressively decreased. Clusters 2 and 3 had more people with an increase in pain following repeated forward and backward spinal bending, and more people with increasing pain following bending,
than cluster 1. Cluster 3 had significantly greater lumbar pressure pain sensitivity, more undiagnosed comorbid symptoms, and more widespread pain than other clusters.
Discussion:
Clinical implications relating to presentations of each cluster are postulated.",
}