• P Arnstein.
• Boston College, Chestnut Hill, MA 02467, USA.
• Disabil Rehabil. 2000 Nov 20; 22 (17): 794-801.

PurposeA path analytic model conceptualizing self efficacy as a mediator of disability was tested. This model could help explain the circumstances under which disability develops more in some chronic pain patients than in others.MethodQuestionnaires from 479 chronic pain patients were collected prior to an initial consultative visit with a pain specialist at three pain clinics. These patients represented three separate samples. One sample from a tertiary care hospital (n = 226), one from a community-based clinic (n = 137) and a third sample from combined settings, but excluding patients with a history of depression prior to the onset of their pain (n = 116). Hypothesized and alternative models were tested to identify the model best fitting these data.ResultsRegression analysis supported self efficacy as a mediator of the relationship between pain intensity and disability (p < 0.001) in all three groups. This model was best supported in the group with no prior depression (accounting for 47% of the explained variance in disability). The 'no-prior depression' group was different than the other samples in that depression did not contribute to disability in this sample where prior depression was not controlled for.ConclusionSelf efficacy in an important variable contributing to the disability of chronic pain patients. Therefore, evaluating and bolstering the patient's belief in their own abilities may be an important component of therapy.

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