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The Pain Recovery Inventory of Concerns and Expectations: A Psychosocial Screening Instrument to Identify Intervention Needs Among Patients at Elevated Risk of Back Disability

Shaw, William S. PhD; Reme, Silje Endresen PhD; Pransky, Glenn MD, MOccH; Woiszwillo, Mary Jane BS; Steenstra, Ivan A. PhD; Linton, Steven J. PhD

Journal of Occupational and Environmental Medicine: August 2013 - Volume 55 - Issue 8 - p 885–894
doi: 10.1097/JOM.0b013e318289ee6c
Original Articles

Objective: To reduce a full psychosocial test battery to a brief screening questionnaire to triage return-to-work strategies among patients with low back pain (LBP).

Methods: Workers (N = 496) with acute, work-related LBP completed multiple psychosocial measures at intake, then a 3-month follow-up of pain, function, and work status. A sensitivity analysis was conducted to reduce the number of items while maintaining scale reliability, preserving associations with outcomes, and maintaining separation between patient subgroups.

Results: The pool of items was trimmed from 129 to 46 items, describing elements of emotional distress, pain beliefs, organizational support, and activity limitation. A confirmatory cluster analysis replicated previous findings of three risk subgroups: distressed, avoidant, and lacking employer support.

Conclusions: The reduced measure is a reliable and valid screening measure that can be used to identify early intervention needs among working adults with LBP.

From the Liberty Mutual Research Institute for Safety (Drs Shaw, Reme, and Pransky and Ms Woiszwillo), Hopkinton, Mass; University of Massachusetts Medical School (Drs Shaw and Pransky), Worcester, Mass; Harvard School of Public Health (Dr Reme), Boston, Mass; Institute for Work and Health (Dr Steenstra), Toronto, Ontario, Canada; and Center for Health and Medical Psychology (Dr Linton), School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden.

Address correspondence to: William S. Shaw, PhD, Liberty Mutual Center for Disability Research, 71 Frankland Rd, Hopkinton, MA 01748 (

This study was an intramural research project of the Liberty Mutual Research Institute for Safety, with travel support from a 2006 International Association for the Study of Pain research grant funded by the Scan/Design Foundation by Inger and Jens Bruun (Linton and Shaw).

Disclosure: The authors declare no conflict of interest.

Copyright © 2013 by the American College of Occupational and Environmental Medicine