Perceived spouse responsiveness to chronic pain: Three empirical subgroups

The spouse plays a fundamental role in day-to-day functioning and long-term well-being of the patient with chronic pain. Although spouses may respond differently to pain demonstrations, no study has examined patterns of perceived spouse responsiveness to chronic pain behavior. Yet perceived patterns of response to chronic pain may explain variability in pain behavior in the literature because studied samples may be drawn from any one subgroup. The purposes of this study were to run an exploratory cluster analysis to identify naturally occurring spouse response subgroups by using section 2 of the Multidimensional Pain Inventory and to examine pain-relevant variables between subgroups. It was hypothesized that subgroups would be identified and that they would differ on pain-relevant variables. Participants were 774 married pain patients from 2 University of Florida-affiliated pain clinics, 69% of whom experienced chronic low back pain. A hierarchical cluster analysis identified 3 subgroups that were labeled positively attentive, negatively attentive, and inattentive. A discriminant analysis yielded 2 significant discriminant functions that correctly classified 71.1% of subgroup membership. The support variable best differentiated between the positively and negatively attentive subgroups, whereas interference best distinguished between the negatively attentive and inattentive subgroups. Results suggest the profiles have conceptual and clinical validity, with the negatively and positively attentive subgroups exhibiting the poorest adjustment to pain. A controlled study is needed to determine the direction of causality. (C) 2001 by the American Pain Society.