Abstract
BACKGROUND: Multidisciplinary programs for treatment of chronic pain are generally effective, yet many patients fail to show significant improvement. The search for predictors of outcome has not explicitly considered sex.OBJECTIVE: To examine mediation and moderation pathways through which sex may predict outcome.DESIGN: Correlational outcome, exploratory, archival study.PARTICIPANTS: A total of 156 chronic pain patients.SETTING: Four-week multidisciplinary pain program.PREDICTOR AND OUTCOME MEASURES: Predictor variables of pain level, activity interference and perceived pain helplessness were culled from patient charts. Outcome was assessed with staff ratings of patient progress.RESULTS: While men responded to treatment more poorly than women, regressions suggested that the greater number of surgeries for men mediated this link. Further analyses revealed that sex acted as a moderator. Among women, perceived pain helplessness was negatively related to outcome, while married women with dissatisfying marriages responded more poorly than unmarried women and women with satisfying marriages. These variables were not significant predictors of outcome among men.CONCLUSIONS: Men and women may be differentially characterized by various risk factors for treatment failure. Moreover, relationships between pretreatment psychosocial factors and outcome may depend on sex.