Study design. Cross sectional.

Objectives. In literature it has been suggested that a strong relationship exists between psychosocial factors and disability in patients with chronic low back pain (CLBP). However, most studies only focus on self reported disability. This study was performed to analyze the relationship between psychological factors and performance based and self-reported disability, as measured with and Functional Capacity Evaluation (FCE) and the Roland Morris Disability Questionnaire (RMDQ), in patients with CLBP.

Methods. The study was performed in an outpatient rehabilitation setting. The study sample consisted of 92 patients with CLBP admitted for multidisciplinary treatment. Prior to treatment, all patients completed questionnaires to measure psychological factors (distress, depression, self efficacy, fear avoidance, pain cognitions and coping style) and self-reported disability, and performed a standardized set of tests in FCE.

Relationships among the variables were measured by means of Pearson correlation coefficients.

Results. Out of 28 relations analyzed, correlations were either non-significant or weak. Correlations between psychosocial factors and FCE were all non-significant, except for one. Results of subgroups will be presented.

Conclusion. The suggested strong relationship between psychological factors and performance based and self-reported disability measures could not be confirmed in this study. This may implicate that the relationship between psychological factors and disability may not be as unambiguous as suggested for patients with CLBP.

Background Context. In the assessment and treatment of patients with chronic low back pain (CLBP) the bio- psycho-social model is used world wide. Psychological distress has been reported to have a strong relationship with self reported disability. The relationship between psychosocial distress measured with the SCL-90-R and self reported disability measured with the RMDQ has not been investigated.

Purpose. To analyze the relationship between psychosocial distress measured with the Symptom Checklist-90-Revised (SCL-90-R) and self reported disability measured with the Roland Morris Disability Questionnaire (RMDQ) in patients with CLBP.

Study design/Setting. This cross sectional study was performed in an outpatient pain rehabilitation setting.

Patient sample. The study sample consisted of 152 patients with CLBP.

Outcome measures. Scores on SCL-90-R and the RMDQ.

Methods. All patients admitted for multidisciplinary treatment completed the SCL-90-R and RMDQ prior to treatment. Pearson’s correlation coefficients between SCL-90-R (Global Severity Index and subscales) and RMDQ were calculated.

Results. Correlation coefficients between SCL-90-R (Global Severity Index and subscales) and RMDQ ranged from 0.18 to 0.31 (p< 0.05).

Conclusion. The relationship between psychosocial distress measured with the SCL-90-R and self reported disability measured with the RMDQ in CLBP patients is weak. For clinical practice it is important to unravel the components and their suggested relationships in the bio-psycho-social model. This research has demonstrated that these relationships cannot be confirmed with the combined use of the SCL-90-R and the RMDQ. Further research is needed to determine which combination of instruments is most suitable to use in clinical practice, and to confirm or refute the suggested impact of psychosocial distress on self reported disability.