Evaluating the role of physical, operant, cognitive, & affective factors in the pain behaviors of chronic pain patients

Behavioral manifestations of pain, distress, and suffering have been

characterized as pain behaviors. Although acquisition and

maintenance of pain behaviors have been considered to occur

through reinforcement contingencies, empirical evidence

suggests that pain behavior is better understood as a

multidimensional entity. The present study was designed to

evaluate the contributions of physical, operant, cognitive,

and affective factors to individual differences in pain

behaviors. A total of 63 chronic pain patients diagnosed with

the disorder fibromyalgia underwent medical, physical, and

psychological evaluations. Hierarchical regression analyses

revealed that the physical, cognitive, and affective factors,

but not operant factors, were significantly related to

observed pain behaviors. The set of all factors accounted for

53% of the variance in observed pain behavior. The results in

this study suggest that pain behaviors should be

conceptualized as behavioral manifestation of pain based on a

complex interaction of various psychological and physical


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