Differing Psychologically Derived Clusters in People With Chronic Low Back Pain are Associated With Different Multidimensional Profiles

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 la...

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Main Authors: Rabey, Martin, Smith, Anne, Beales, Darren, Slater, Helen, O'Sullivan, Peter
Format: Journal Article
Published: 2016
Online Access:http://hdl.handle.net/20.500.11937/31509
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author Rabey, Martin
Smith, Anne
Beales, Darren
Slater, Helen
O'Sullivan, Peter
author_facet Rabey, Martin
Smith, Anne
Beales, Darren
Slater, Helen
O'Sullivan, Peter
author_sort Rabey, Martin
building Curtin Institutional Repository
collection Online Access
description 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.
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spelling curtin-20.500.11937-315092017-09-13T15:34:03Z Differing Psychologically Derived Clusters in People With Chronic Low Back Pain are Associated With Different Multidimensional Profiles Rabey, Martin Smith, Anne Beales, Darren Slater, Helen O'Sullivan, Peter 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. 2016 Journal Article http://hdl.handle.net/20.500.11937/31509 10.1097/AJP.0000000000000363 fulltext
spellingShingle Rabey, Martin
Smith, Anne
Beales, Darren
Slater, Helen
O'Sullivan, Peter
Differing Psychologically Derived Clusters in People With Chronic Low Back Pain are Associated With Different Multidimensional Profiles
title Differing Psychologically Derived Clusters in People With Chronic Low Back Pain are Associated With Different Multidimensional Profiles
title_full Differing Psychologically Derived Clusters in People With Chronic Low Back Pain are Associated With Different Multidimensional Profiles
title_fullStr Differing Psychologically Derived Clusters in People With Chronic Low Back Pain are Associated With Different Multidimensional Profiles
title_full_unstemmed Differing Psychologically Derived Clusters in People With Chronic Low Back Pain are Associated With Different Multidimensional Profiles
title_short Differing Psychologically Derived Clusters in People With Chronic Low Back Pain are Associated With Different Multidimensional Profiles
title_sort differing psychologically derived clusters in people with chronic low back pain are associated with different multidimensional profiles
url http://hdl.handle.net/20.500.11937/31509