title: Negative beliefs about low back pain are associated with high pain intensity and high level disability in community-based women.
abstract: BACKGROUND
  Although previous studies have investigated beliefs about back pain in clinical and employed populations, there is a paucity of data examining the beliefs of the broader community. We aimed to characterize the beliefs that community-dwelling women have about back pain and its consequences, and to determine whether those with varying levels of pain intensity and disability differ in their beliefs.
  
  
  METHODS
  542 community-dwelling women, aged 24 to 80 years, were recruited from a research database. Participants completed a self-administered questionnaire that included detailed demographic information, the Chronic Pain Grade Questionnaire (CPG) and the Back Beliefs Questionnaire (BBQ). The CPG examined individuals' levels of pain intensity and disability, and the BBQ investigated their beliefs about back pain and its consequences.
  
  
  RESULTS
  506 (93.4%) women returned the study questionnaire. The mean (SD) BBQ score for the cohort was 30.7 (6.0), indicating generally positive beliefs about back pain. However, those women with high intensity pain and high level disability had a mean (SD) score of 28.5 (5.7) and 24.8 (5.7) respectively, which reflects greater negativity about back pain and its consequences. There was an association between negative beliefs and high pain intensity (OR = 0.94 (95% CI: 0.90, 0.99), p = 0.01) and high level disability (OR = 0.93 (95% CI: 0.89, 0.97), p = 0.001), after adjusting for confounders.
  
  
  CONCLUSIONS
  This study highlights that although women living in the community were generally positive about back pain, subgroups of women with high pain intensity and high level disability were identified who had more pessimistic views. While a causal relationship cannot be inferred from these cross-sectional data, the results suggest that negative beliefs individuals have about back pain may be predictive of chronic, disabling spinal pain.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia. Donna.Urquhart@med.monash.edu.au
authors.forename: Donna M
authors.initials: DM
authors.lastname: Urquhart
authors.forename: Robin J
authors.initials: RJ
authors.lastname: Bell
authors.forename: Flavia M
authors.initials: FM
authors.lastname: Cicuttini
authors.forename: Jisheng
authors.initials: J
authors.lastname: Cui
authors.forename: Andrew
authors.initials: A
authors.lastname: Forbes
authors.forename: Susan R
authors.initials: SR
authors.lastname: Davis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D055812:Community-Based Participatory Research; D003430:Cross-Sectional Studies; D003469:Culture; D004185:Disability Evaluation; D005260:Female; D006306:Health Surveys; D006801:Humans; D017116:Low Back Pain / Q000453:epidemiology / Q000523:psychology*; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014739:Victoria