Psychosocial and Demographic Correlates of Employment vs Disability Status in a National Community Sample of Adults with Chronic Pain: Toward a Psychology of Pain Presenteeism

Abstract

Background Although chronic pain is a source of work-related disability, relatively little research has addressed the psychological factors that differentiate individuals in chronic pain who leave the workforce from those who remain on the job despite their pain. Objective The present study examined a small set of attitudinal and coping-related factors as potential correlates of pain-related disability versus continued part- or full time employment over and above the role of well-known risk factors. Methods A large sample of adult men and women with chronic pain drawn from across the United States (N= 1293) by means of random digit dialing was subdivided into two groups: working (N = 859) and on disability (N = 434). Both groups were interviewed (by telephone) to complete a set of instruments (called the Profile of Chronic Pain: Extended Assessment [PCP: EA] Battery) measuring pain attitudes and coping methods. Results Logistic regression analysis revealed, as expected, that continued employment status was inversely related to pain severity and work status was positively related to higher education and being Hispanic. After controlling for severity and demographic factors, belief in a medical cure and catastrophizing tendencies were significant inverse predictors and task persistence was a positive predictor of continued employment. Conclusions Results revealed both demographic and attitudinal predictors of continued employment, and highlight the value of harnessing insights from the psychology of work engagement to better understand the processes underlying pain presenteeism. Interventions designed to keep persons with pain in the active work force should build upon and extend the present findings.

Person-related factors associated with work participation in employees with health problems: a systematic review

“…(2017) a, g Iakova et al (2012)Karoly et al (2013) d Norlund et al (2011)Strober and Arnett (2016) a Arwert et al (2017) a Dawson et al (2011) a, d De Vries et al . (2012b) Grytten et al .…”

“…(2012) f, g De Vries et al . (2012b)Karoly et al (2013) Lindell et al . (2010) b Wijnhoven et al (2007)Besen et al (2015) Cowan et al (2012) f, g Dawson et al (2011)Karels et al (2010)Mannion et al (2009) Morris and Watson (2011) d Sarda et al (2009) Spector et al (2012) Turner et al (2008)

Bold indicates studies with a low risk of bias

a Depends on the form/subscale of the factor

b Not for every moment on which the outcome is measured

c Depends on the type of disorder of the participant

d Outcomes from univariate analysis

e Depends on the gender of the participant

f Depends on the job of the participant

g Depends on the form of work participation

h  Outcomes from bivariate analysis

i Fear-avoidance beliefs for movement/physical activity

j Fear-avoidance beliefs for work

k Total fear-avoidance

…”

“…In total, 14 quantitative studies investigated the association between different coping strategies and work participation (Table 2: Arwert et al 2017; Dawson et al 2011; De Vries et al 2012b; Grytten et al 2017; Heymans et al 2009; Huijs et al 2012; Iakova et al 2012; Karoly et al 2013; Luk et al 2010; Norlund et al 2011; Øyeflaten et al 2008, 2016; Strober and Arnett 2016; Truchon et al 2010). Nine studies found an effect of some coping strategies (Arwert et al 2017; Dawson et al 2011; Grytten et al 2017; Huijs et al 2012; Iakova et al 2012; Karoly et al 2013; Norlund et al 2011; Øyeflaten et al 2008; Strober and Arnett 2016).…”

Elements of the Biopsychosocial Interview of the Chronic Pain Patient: A New Expanded Model Using Rational Emotive Behavior Therapy

“…Patients pursuing benefits whether through the government or private insurance such as in worker's compensation insurance may have an unconscious incentive to remain sick or at least sicker in order to obtain benefits. Karoly et al (2013) found that subjects (N = 1252) who remained at work had significantly higher adaptive coping style (non-catastrophizing, task persistence, and trust in medical care) controlling for pain severity and psychiatric illness. For patients who are undergoing stressful worker's compensation experiences, this stress has proven to negatively impact medical outcome in the short and long term (6 years) (Grant et al 2014).…”

Affect, work-goal schemas, and work-goal striving among adults with chronic pain: a multilevel structural equation analysis

“…Recent studies have identified a set of attitudinal, personality, and coping factors that distinguish between people in pain who are able to remain partially or fully employed and those who do not (de Vries et al, 2013;Karoly et al, 2013). Nevertheless, research is needed that delves more deeply into the time-and event-sensitive daily motivational patterns of working individuals with chronic pain.…”