No abstract

Locus of control (LOC) beliefs, long thought important in adjustment to persistent pain, were studied among 160 subjects (67 males and 93 females) referred to a comprehensive pain rehabilitation program. The subscale structure of the Multidimensional Health Locus of Control (MHLC) was factorially replicated in our sample. Three unique MHLC profile clusters were identified for both males and females. Among men, cluster assignment was related to age only. The younger male patients reported a stronger internal attributional style. Older male patients relied more heavily on both chance and powerful other factors. Among women, cluster assignment was related to the use of coping strategies. For example, patients with high internal scores only, reflecting a strong internal orientation towards self-management of health care needs, were more likely to utilize Information-Seeking, Self-Blame, and Threat Minimization coping strategies than patients with high scores on both the Internal and Powerful Other factors. It appears that the presence of both Internal and Powerful Other health attributional styles is associated with less frequent use of cognitive self-management techniques. In understanding the LOC scores it is important to rely on pattern analysis of scores. Implications for clinical treatment are discussed.

Chronic pain patients frequently report that weather conditions affect their pain; however, no standardized measures of weather sensitivity have been developed. We describe the development and use of the Weather and Pain Questionnaire (WPQ) which assess patient sensitivity to meteorologic variables defined by the National Weather Service (e.g., temperature, precipitation). Seventy chronic pain patients (59% females) with an average age of 43 years completed the WPQ. The instrument was revised using factor analysis to produce a Weather Sensitivity Index (WSI) (48% of variance) with high internal consistency (0.93) and test-retest reliability (r = 0.89). Reporting patterns suggested that patients could reliably identify which meteorologic variables influenced their pain but could not reliably determine which physical symptoms were consistently affected. The most frequently reported meteorologic variables which affect pain complaint were temperature (87%) and humidity (77%). The most frequently reported physical complaints associated with the weather were joint and muscle aches (82% and 79%, respectively). Patients labeled as being 'weather sensitive', defined by greater than median scores on the WPQ, reported significantly greater pain intensity, greater chronicity of pain problems, and more difficulties sleeping than patients with low scores on the WPQ. No differences in gender, education level, disability status, or global psychological distress were found. Results are discussed with respect to physiological and psychological mediating variables.