Pain-related and General Distress Among Adults Seeking Pain Psychology Treatment

Objectives: People with chronic pain often experience symptoms of pain-related distress (eg, kinesiophobia, catastrophizing) and general distress (eg, depression, anxiety). Identifying distinct profiles of distress among patients seeking pain psychology treatment can inform personalized pain psychology interventions. Among adults seeking pain psychology treatment, the current study applied latent profile analysis (LPA) to (1) identify distinct patient symptom profiles (based on kinesiophobia, catastrophizing, depression, and anxiety) and (2) characterize pain-related symptoms and demographics of each profile. Methods: Adults scheduled for a pain psychology evaluation who completed a clinical battery of patient-reported outcome measures were included. LPA was applied to identify distinct subgroups of patients based on psychological symptoms. The resulting groups were compared on pain-related and demographic factors. Results: Participants were 548 adults (mean age=51.1; predominantly white [66.6%] and female [67.5%]). Two profiles were identified: “global distress” (67.2%, elevated clinical symptoms in all domains) and “localized and mild kinesiophobia” (32.8%, subclinical symptoms in all domains, except mild kinesiophobia). The “global distress” group was younger ( d =0.23) and had higher levels of area deprivation ( d =0.23). They had higher pain intensity ( d =0.76), functional disability ( d =0.72), and opioid misuse risk ( d =1.21). Discussion: Among adults seeking pain psychology treatment, most experienced elevated distress across pain-specific and general domains. A minority experienced subclinical symptoms, with focal and mild kinesiophobia. The findings highlight a wide range of pain psychology needs among adults with chronic pain seeking psychology treatment, and highlight the value in treatment options that span intensity and breadth.