Assessing the stages of pain processing: a multivariate analytical approach

Pain. 1996 Nov;68(1):157-167. doi: 10.1016/S0304-3959(96)03162-4.

Abstract

A four-stage model of pain processing was proposed, consisting of pain sensation intensity, pain unpleasantness (stage 1 affect), suffering (stage 2 affect), and pain behavior. We studied 506 chronic pain patients (230 male and 276 female) using a multivariate statistical technique (LISREL) in order to demonstrate the structural relationship among multiple indicators of pain processing; and to characterize these stages in terms of their interactions. A strong relationship was revealed between the majority of the underlying indicators of each pain processing stage. A linear stage sequence best fitted the relationship between the four stages. Successive stages did not have recursive effects on earlier pain components. A confirmatory LISREL analysis was conducted with an additional sample of 502 chronic pain patients. In this replication analysis the structural equation model consisted of pain intensity, unpleasantness (stage 1 affect), emotional suffering (stage 2 affect), and pain behavior. This study extends the validation of these pain dimensions, as well as the validity of the measure(s) of each separate stage.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Affect / physiology*
  • Aged
  • Aged, 80 and over
  • Behavior / physiology*
  • Chronic Disease
  • Evaluation Studies as Topic
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pain / physiopathology*
  • Reproducibility of Results
  • Stress, Psychological / physiopathology*