Observational assessment of chronic pain patient-spouse behavioral interactions

Abstract

A methodology for the observational assessment of behavioral interactions between chronic pain patients and their spouses was developed and evaluated. Chronic pain patients and their spouses (n=50 couples) and healthy controls (n=33 couples) were videotaped while performing a series of tasks. Behaviors of both partners were coded from the videotapes. All subjects also completed a set of self-report measures scheme showed acceptable interrater agreement and discriminated pain and control groups on the basis of overt as well as self-reported behavior as predicted by operant theory. Pain patients showed higher rates of overt nonverbal and verbal pain behaviors compared to controls, spouses of pain patients showed more solicitous behavior than did control spouses, and pain patients and their spouses showed less facilitative behavior than did controls. The coding scheme also demonstrated convergent validity in that code categories correlated significantly with self-report measures as similar construct. The results suggest that this methodolgy and coding system are potentially useful tools for addressing important theoretical and clinical questions related to the operant model of chronic pain behavior. of physical and psychological functioning. Results indicated that the behavioral coding