Pain-related Activity Patterns: Measurement, Interrelationships, and Associations With Psychosocial Functioning

OBJECTIVES:Changes in activity frequently occur as a consequence of ongoing pain. Three activity patterns commonly observed among individuals with ongoing pain are avoidance, overdoing, and pacing. We conducted 2 studies investigating these activity patterns, their interrelationships, and their associations with key psychosocial factors. Study 1 describes the development of a measure, the Patterns of Activity-Pain (POAM-P), to assess these activity patterns; Study 2 examines the psychosocial correlates of these activity patterns. METHODS:In study 1, a sample of 393 individuals with chronic pain responded to a pool of 51 items assessing activity as part of their pretreatment assessment. Item analyses were conducted to create a 30-item measure with 3, 10-item scales assessing avoidance, overdoing, and pacing. In study 2, a sample of 164 individuals attending a follow-up program 3 months after treatment completed the POAM-P along with measures of affect, pain control, and disability. RESULTS:The scales demonstrated excellent internal consistency and correlations with other measures provided initial support for construct validity. Avoidance and overdoing were associated with negative psychosocial outcomes whereas pacing was associated with positive outcomes. In contrast to previous studies, pacing and avoidance were unrelated. DISCUSSION:The POAM-P has excellent psychometric properties and may be useful in clinical practice to identify activity patterns associated with poorer functioning and to evaluate interventions intended to modify these activity patterns. The present results support previous findings linking avoidance and various negative outcomes. These results also provide evidence that pacing may be related to positive outcomes after treatment.