Exploring Differences in Pain Beliefs Within and Between a Large Nonclinical (Workplace) Population and a Clinical (Chronic Low Back Pain) Population

Beliefs, cognitions and behaviours regarding pain can be associated with a range of negative outcomes. In patients, particular beliefs are associated with greater levels of pain and related disability. There is not much data however, showing how different the beliefs of patients are from those of the general population. The authors conducted this study examining pain beliefs in a large non-clinical population and a chronic low back pain (CLBP) sample using the Pain Beliefs Questionnaire (PBQ) so that they might identify differences in scores and factor structures between and within the samples. The samples were made up of patients participating in a rehabilitation programme and respondents to a workplace survey. Pain beliefs were assessed using the PBQ which incorporates two scales – ‘organic’ and ‘psychological’. They applied exploratory factor analysis to explore variations in factor structure within and between samples. The relationship between the two scales was also examined. They found that patients reported higher organic scores and lower psychological scores than the nonclinical sample. Within the non-clinical sample, those who reported frequent pain scored higher on the organic scale than those who did not. Factor analysis showed variations in relation to the presence of pain. The relationship between scales was stronger in those not reporting frequent pain. The authors point out that it was a cross-sectional study; so it is not possible to make causal inferences.


The study concluded that patients dealing with CLBP take on a more biomedical perspective on pain than non-patients. They also found that the presence of pain had an association with greater ‘biomedical thinking’ in a non-clinical sample. However, the impact is not just on the strength of beliefs, but also on the relationship between elements of belief and the underlying belief structure.