Participant's perception of negative cognition in low back pain: a pilot study.
OBJECTIVE
It has been theorized that low back pain contributes to the development of negative cognition (negative thinking) which may predispose a person towards chronicity. The objective of this paper is to examine the role of negative cognition in non-depressed participants who have previously experienced low back pain.


METHODS
Ten students enrolled in a course at the University of Kansas were involved in a 4 week educational project. The participants completed self-rated assessments of depression using the 21 item Beck Depression Inventory (BDI-21) and the visual analogue pain scale (VAS). The study was broken into 3 phases over 4 weeks. Phase 1 focused on the VAS and the BDI-21 along with questions pertaining to low back pain. Phase 2 included 2 questions with 1 of the questions focusing on common negative distortions. Phase 3 focused on 11 clinical-type questions relating to awareness of negative thinking and chronic low back pain.


RESULTS
Phase 1 showed that 7 of the students had a history of chronic low back pain while 8 students believed they had negative thoughts when low back pain occurred. Conversely, only 1 student had experienced negative thoughts prior to a low back pain episode. The initial BDI-21 scores demonstrated a mean score of 5.5 with a mean VAS of 5.75. After students were exposed to the idea that they may have negative cognition processes (phase 2), 4 students indicated that they noticed themselves thinking negatively and attempted to alter such processes. Phase 3 results indicated that 4 of the students did attempt to change negative thinking after being made aware that negative thinking could be present.


CONCLUSIONS
The results of this study showed that a majority of participants believed that a person's negative thoughts can impair a person toward activity yet none of the participants believed that such had occurred to them. Further research in the area of negative cognition and chronic low back pain is needed.
Mirtz
Timothy A
TA
Department of Health Sport and Exercise Science, University of Kansas, Lawrence, KS.
Greene
Leon
L
Thompson
Mark A
MA
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