Experience of pain in rheumatoid arthritis--an empirical evaluation of the contribution of developmental psychosocial stress.

Using a structured biographical history we evaluated the relationship between aspects of development and reports of pain experience (i.e. intensity of pain, affective and affective-evaluative dimensions of pain according to the McGill pain questionnaire, and effectiveness of medication) in 66 patients with rheumatoid arthritis. It was postulated that higher loading with regard to developmental stress would have a negative influence on reports of pain experience. Multiple regression analysis showed that (i) the intensity of pain was significantly correlated with the functional stage of the illness, (ii) affective and affective-evaluative dimensions of pain experience correlated with the interviewer's scoring of nurture and the patient's relationship with his or her partner, and (iii) the effectiveness of medication was significantly associated with the partner's understanding of the patient's pain and duration of illness. However, independent variables could explain only part of the variance (i.e. 12% for pain intensity, 17% for affective and affective-evaluative dimensions of pain experience and 26% for the effectiveness of medication). These results suggest that the previously assumed importance of developmental psychosocial stress as a factor in chronic intractable pain may require careful reassessment.