Effects of self-discrepancies on activity-related behaviour: explaining disability and quality of life in patients with chronic low back pain

Pain. 2011 Sep;152(9):2165-2172. doi: 10.1016/j.pain.2011.05.028. Epub 2011 Jun 30.


In chronic low back pain (CLBP) research, the self-discrepancy model has been applied to explain dysfunctional avoidance and persistence behaviour. The main aim of this study was to evaluate whether specific self-discrepancies in patients with CLBP are associated with the abovementioned types of activity-related behaviour and whether changes in self-discrepancies over time are associated with changes in activity-related behaviour. Furthermore, the aim was to evaluate whether avoidance and persistence behaviour are associated with a higher level of disability and a diminished quality of life and whether changes over time in avoidance and persistence behaviour result in changes in disability and quality of life. A longitudinal cohort study in a sample of patients with CLBP (N=116), in which self-discrepancies, disability, quality of life, and objectively registered characteristics of activity-related behaviour were measured, was performed to evaluate the pathways in the aforementioned self-discrepancy model. Results indicate that patients with CLBP who feel closer to their ideal-other show more characteristics of persistence behaviour. Patients who move further away from their ideal-own also show more characteristics of persistence behaviour. Furthermore, in patients characterized as avoider, a decrease in a patient's daily uptime was associated with a decrease of mental health-related quality of life.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chronic Pain / diagnosis
  • Chronic Pain / physiopathology
  • Chronic Pain / psychology
  • Cohort Studies
  • Disability Evaluation*
  • Female
  • Follow-Up Studies
  • Humans
  • Low Back Pain / diagnosis
  • Low Back Pain / physiopathology
  • Low Back Pain / psychology*
  • Male
  • Middle Aged
  • Motor Activity / physiology*
  • Pain Measurement / methods
  • Pain Measurement / psychology*
  • Quality of Life / psychology*