Psychosocial and demographic correlates of employment vs disability status in a national community sample of adults with chronic pain: Toward a psychology of pain presenteeism

Background: Although chronic pain is a source of work-related disability, relatively little research has addressed the psychological factors that differentiate individuals in chronic pain who leave the workforce from those who remain on the job despite their pain. Objective: The present study examined a small set of attitudinal and coping-related factors as potential correlates of pain-related disability vs continued part- or full-time employment over and above the role of well-known risk factors. Methods: A large sample of adult men and women with chronic pain drawn from across the United States (N=1,293) by means of random digit dialing was subdivided into two groups: working (N=859) and on disability (N=434). Both groups were interviewed (by telephone) to complete a set of instruments (called the Profile of Chronic Pain: Extended Assessment battery) measuring pain attitudes and coping methods. Results: Logistic regression analysis revealed that continued employment status was inversely related to pain severity and was positively related to higher education and being Hispanic. After controlling for severity and demographic factors, belief in a medical cure and catastrophizing tendencies were significant inverse predictors, and task persistence was a positive predictor of continued employment. Conclusions: Results revealed both demographic and attitudinal predictors of continued employment and highlight the value of harnessing insights from the psychology of work engagement to better understand the processes underlying pain presenteeism. Interventions designed to keep persons with pain in the active work force should build upon and extend the present findings.