title: The impact of psychosocial factors on neck pain and disability outcomes among primary care patients: results from the UCLA Neck Pain Study.
abstract: OBJECTIVE
  The purpose of this study is to estimate the associations of psychosocial factors with pain and disability outcomes among neck-pain patients enrolled in a randomized clinical trial of chiropractic treatments.
  
  
  METHODS
  Neck-pain patients were randomized to one of 8 modes of chiropractic treatment. Health status and psychosocial variables were measured at baseline. Changes in neck pain severity and disability from baseline to 6 months were the primary outcome variables. Multivariable regression models were used to estimate effects of psychosocial variables adjusted for potential confounders.
  
  
  RESULTS
  Of 960 eligible patients, 336 were enrolled and 80% were followed up through 6 months. Coping strategies involving self-assurance resulted in better disability outcomes, whereas getting angry or frustrated resulted in worse pain and disability outcomes. Participants with high levels of social support from individuals were more likely to experience clinically meaningful reductions in pain and disability. No consistent relations of internal health locus of control, and physical and psychological job demands with improvements in pain and disability were detected.
  
  
  CONCLUSIONS
  We found some evidence that certain coping strategies and types of social support are associated with pain and disability outcomes in this population of largely subacute and chronic neck-pain patients.
authors.affiliation: Department of Epidemiology, UCLA School of Public Health, Los Angeles, California, USA. ehurwitz@hawaii.edu
authors.forename: Eric L
authors.initials: EL
authors.lastname: Hurwitz
authors.forename: Michael S
authors.initials: MS
authors.lastname: Goldstein
authors.forename: Hal
authors.initials: H
authors.lastname: Morgenstern
authors.forename: Lu-May
authors.initials: LM
authors.lastname: Chiang
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007389:Internal-External Control; D016018:Least-Squares Analysis; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000523:psychology* / Q000534:rehabilitation*; D016017:Odds Ratio; D011320:Primary Health Care; D011379:Prognosis; D012944:Social Support