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. 2018 Nov 15;13(11):e0207173.
doi: 10.1371/journal.pone.0207173. eCollection 2018.

Interpersonal problem behavior and low back pain

Constanze Borys  1 , Steffi Nodop  1 , Christoph Anders  2 , Robin Tutzschke  2 , Hans Christoph Scholle  2 , Andrea Thomas  1 , Uwe Altmann  1 , Bernhard Strauss  1
Affiliations

Interpersonal problem behavior and low back pain

Constanze Borys et al. PLoS One. .

Abstract

Objective: The theory of interpersonal problem behaviour (IPB) provides a more fundamental framework for understanding the psychosocial aspects of pain. The present study focused on the IPB, based on the Interpersonal Problem Circumplex (IPC), in persons with low back pain and its association with pain, psychological characteristics, and health care utilisation.

Methods: In a cross-sectional design, individuals with back pain (N = 88) and healthy control persons who matched by age, gender, and educational level (N = 88) were compared with regard to IPB. Furthermore, back pain patients classified by their IPB (N = 24 low, N = 48 moderate, N = 16 high) were compared regarding pain, depression, catastrophising, and health care utilisation.

Results: In comparison to the healthy reference sample, a significant difference in the interpersonal problems of the low back pain group, with a tendency towards being overly 'introverted', 'exploitable', and 'subassertive', was revealed. In the back pain group, participants with elevated IPB showed significantly higher levels of pain intensity, functional disability, depression, catastrophising, and health care utilisation than participants with IPB in the normal range.

Conclusion: Application of the Interpersonal Circumplex Model can help to characterize a subgroup of persons with low back pain. Increased general interpersonal problems are associated with elevated burden in pain-related, psychological, and health care-related variables. Future research should focus on the treatment opportunities for this subgroup, as well as on the influence of interpersonal problems during the course of back pain.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Interpersonal problem circumplex (IPC), based on Horowitz et al. [15], modified version.
Fig 2
Fig 2. IIP profile (means) of participants of the New German Back School (N = 88), matched reference group (N = 88), and German norm data.
See this image and copyright information in PMC

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