title: Cognitive-behavioral classifications of chronic pain in patients with multiple sclerosis.
abstract: The aim of this study was to replicate, in patients with multiple sclerosis (MS), the three-cluster cognitive-behavioral classification proposed by Turk and Rudy. Sixty-two patients attending a tertiary MS rehabilitation center completed the Pain Impact Rating questionnaire measuring activity interference, pain intensity, social support, and emotional distress. The General Health Questionnaire-28 and the Multiple Sclerosis Impact Scale-29 assessed disability and restriction in participation. Cluster analysis classified patients into three cognitive-behavioral groups (40.4%, 'adaptive copers'; 36.5%, 'dysfunctional'; and 23.1%, 'interpersonally distressed'). Patients in groups with higher levels of activity interference, emotional distress due to pain, and lower perceived levels of social support had significantly higher levels of depression on the General Health Questionnaire-28 (P<0.003), and reported a greater impact on their physical and psychological functioning (P<0.001) on Multiple Sclerosis Impact Scale-29 subscales. Possible cut-points were identified to aid clinicians in classifying patients into clusters for individualized treatment. More research is needed to improve the understanding of pain and the potential use of cognitive-behavioral clusters in patients with MS. These may be useful in the development of tailored early intervention, which may reduce pain-related disability and contribute to patient's overall well being.
authors.affiliation: Department of Medicine, Dentistry and Health Sciences, University of Melbourne, Shepparton, Victoria, Australia.
authors.forename: Fary
authors.initials: F
authors.lastname: Khan
authors.forename: Julie F
authors.initials: JF
authors.lastname: Pallant
authors.forename: Bhasker
authors.initials: B
authors.lastname: Amatya
authors.forename: Kevin
authors.initials: K
authors.lastname: Young
authors.forename: Steven
authors.initials: S
authors.lastname: Gibson
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000223:Adaptation, Psychological; D000328:Adult; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D004185:Disability Evaluation; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000523:psychology* / Q000534:rehabilitation*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000523:psychology* / Q000534:rehabilitation*; D009460:Neurologic Examination; D010146:Pain / Q000145:classification* / Q000523:psychology* / Q000534:rehabilitation; D010147:Pain Measurement / Q000523:psychology*; D011446:Prospective Studies; D012803:Sick Role; D012944:Social Support; D014739:Victoria