title: Assessing the stages of pain processing: a multivariate analytical approach.
abstract: A four-stage model of pain processing was proposed, consisting of pain sensation intensity, pain unpleasantness (stage 1 affect), suffering (stage 2 affect), and pain behavior. We studied 506 chronic pain patients (230 male and 276 female) using a multivariate statistical technique (LISREL) in order to demonstrate the structural relationship among multiple indicators of pain processing; and to characterize these stages in terms of their interactions. A strong relationship was revealed between the majority of the underlying indicators of each pain processing stage. A linear stage sequence best fitted the relationship between the four stages. Successive stages did not have recursive effects on earlier pain components. A confirmatory LISREL analysis was conducted with an additional sample of 502 chronic pain patients. In this replication analysis the structural equation model consisted of pain intensity, unpleasantness (stage 1 affect), emotional suffering (stage 2 affect), and pain behavior. This study extends the validation of these pain dimensions, as well as the validity of the measure(s) of each separate stage.
authors.affiliation: Department of Psychiatry, at the Medical College of Virginia/Virginia Commonwealth University, Richmond,Virginia, 23298USA Department of Gerontology, at the Medical College of Virginia/Virginia Commonwealth University, Richmond,Virginia, 23298USA Department of Anesthesiology, at the Medical College of Virginia/Virginia Commonwealth University, Richmond,Virginia, 23298USA Department of Psychology, at the Medical College of Virginia/Virginia Commonwealth University, Richmond,Virginia, 23298USA.
authors.forename: James B
authors.initials: JB
authors.lastname: Wade
authors.forename: Linda M
authors.initials: LM
authors.lastname: Dougherty
authors.forename: Ray C
authors.initials: RC
authors.lastname: Archer
authors.forename: Donald D
authors.initials: DD
authors.lastname: Price
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect / Q000502:physiology*; D000368:Aged; D000369:Aged, 80 and over; D001519:Behavior / Q000502:physiology*; D002908:Chronic Disease; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010146:Pain / Q000503:physiopathology*; D015203:Reproducibility of Results; D013315:Stress, Psychological / Q000503:physiopathology*