CoChat
Sign Up
Cited by 179Musculoskeletal pain and rehabilitationPain Management and TreatmentPediatric Pain Management Techniques

Chronic pain and sex-differences; women accept and move, while men feel blue

Open access
Rovner, Graciela S., Sunnerhagen, Katharina S., Björkdahl, Ann, Gerdle, Björn, Börsbo, Björn, Johansson, Fredrik, Gillanders, David·2017·PLOS ONE
DOI 10.1371/journal.pone.0175737PMC PMC5404887
Open this paper in CoChat — free accountOpen PDF

Abstract

PURPOSE: The aim of this study is to explore differences between male and female patients entering a rehabilitation program at a pain clinic in order to gain a greater understanding of different approaches to be used in rehabilitation. METHOD: 1371 patients referred to a specialty pain rehabilitation clinic, completed sociodemographic and pain related questionnaires. They rated their pain acceptance (CPAQ-8), their kinesiophobia (TSK), the impact of pain in their life (MPI), anxiety and depression levels (HAD) and quality of life scales: the SF-36, LiSat-11, and the EQ-5D. Because of the large sample size of the study, the significance level was set at the p ≤.01. RESULTS: Analysis by t-test showed that when both sexes experience the same pain severity, women report significantly higher activity level, pain acceptance and social support while men report higher kinesiophobia, mood disturbances and lower activity level. CONCLUSION: Pain acceptance (CPAQ-8) and kinesiophobia (TSK) showed the clearest differences between men and women. Pain acceptance and kinesiophobia are behaviorally defined and have the potential to be changed.

Verified 2026-10-09 · 1 reference not checked yet

AI snapshot

Written from the paper’s full text.

TL;DR

In 1,371 patients referred to a Swedish specialty pain rehabilitation clinic, women and men reported similar pain severity, but women showed higher pain acceptance, activity engagement, and social/life satisfaction, while men showed higher kinesiophobia and worse mental health. The clearest sex differences were in pain acceptance (CPAQ-8) and kinesiophobia (TSK), both behaviorally defined and potentially modifiable in rehabilitation.

Key findings

  • At comparable pain severity (MPI pain severity: women 4.54 vs men 4.43, p = .123), women reported significantly higher pain acceptance: CPAQ-8 Activity Engagement 13.46 vs 11.45 (p < .001, d = .21) and Pain Willingness 10.08 vs 8.36 (p < .001, d = .33).
  • Men reported significantly higher kinesiophobia (TSK: 43.52 vs 39.50, p < .001, d = -.44) and lower general activity level (MPI: 2.16 vs 2.36, p < .001, d = .21).
  • Men scored significantly lower on SF-36 Mental Health than women (52.47 vs 56.53, p = .007, d = .18), while HAD anxiety and depression did not differ significantly (anxiety p = .245; depression p = .056).
  • Women had more pain locations (14 vs 10, p < .001, d = .50) and more widespread pain (35.1% vs 21.8%, p < .001), and reported higher satisfaction with life as a whole, friends/acquaintances, sexual life, and family life.

Methods

  • Cross-sectional pre-rehabilitation data from 1,371 consecutive patients with chronic musculoskeletal non-malignant pain referred to the Pain and Rehabilitation Centre, University Hospital, Linköping, Sweden, between 2009 and April 2011; 68.4% were women.
  • Participants completed sociodemographic and pain-related questionnaires including CPAQ-8, TSK, MPI, HAD, SF-36, LiSat-11, and EQ-5D.
  • Analyses used descriptive statistics, chi-squared tests, and two-tailed t-tests, with significance set at p ≤ .01 and “highly” significant at p ≤ .001; Cohen’s d effect sizes were calculated, and missing data were excluded pairwise.

Limitations

  • The authors state that the large sample size can produce statistically significant but small-magnitude differences; effect sizes were sometimes low, and results should be treated with caution.
  • The authors note reliance on self-reports, lack of observational measures such as physical capacity or sedentary time, and a heterogeneous sample with large SDs; they also state that exploratory cross-sectional design prevents causal inferences or conclusions about treatment response.
  • Evident from the text: several analyses had smaller subsamples than the full 1,371 (e.g., TSK n = 869; CPAQ-8 Pain Willingness n = 1,086), and the sample was predominantly women, which may affect generalizability.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1371/journal.pone.0175737

Cites

76 of 77 references verified0 citation errors · 0 not checkable

Statistics

3 tests recomputed · 0 with the reported and recomputed p on opposite sides of .05

Claims the paper makes

0 of 60 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Men scored significantly lower than women on the SF-36 Mental Health subscale (mean difference = 4.08, 99% CI: 0.18 to 7.98, d = .18).

    “according to the Mental Health subscale of SF-36, men scored significantly lower than women, indicating that men were experiencing more problem with their mental health than women t(1109) = 2.78, p = .007, d = .18 (mean difference = 4.08, 99% CI: 0.18 to 7.98) (Table 3).”
    Quote in the paperSubstantial claim
  • Findingown data

    In this clinical sample, women were more likely to report widespread pain than men.

    “35% of them suffered from widespread pain while the majority of men (78%) suffered from localized pain χ2 (one, n = 1283) = 22.63, p = .000 (Table 1).”
    Quote in the paperNot a substantial claim
  • Findingown data

    There was no statistically significant difference in anxiety according to HAD between men and women.

    “showing no statistically significant difference in anxiety according to HAD.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Women reported a greater number of pain locations than men (mean difference = 4.032, 99% CI: 2.82 to 5.24, d = .50).

    “women reported a greater number of pain locations than men t (1316) = 8.63, p = < .0001, d = .50. The magnitude of the differences in these means was large (mean difference = 4.032, 99% CI: 2.82 to 5.24).”
    Quote in the paperNot a substantial claim
  • Findingown data

    More men than women scored at a level of depression on HAD.

    “More men than women (34% vs 30%) scored at a level of depression.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 27
  • The quote only partly states this claim. 3
  • May combine two claims. 15

  • Probably not a substantial claim: may not pass S3 (load-bearing). The quote only partly states this claim.

    Findingown data

    More women were born in Sweden than men.

    “and more were born in Sweden (Table 1).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Women were significantly younger than men (M = 45 vs. 51, d = .41).

    “Women were significantly younger than men (Age M = 45 vs. men’s M = 51) t (1367) = -6.52, p < .001, d = .41 (Table 2)”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Of the 1371 patients, 68.4% were women.

    “Of the 1371 patients, 68.4% were women”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    Women were more likely to work to some extent than men.

    “while most women were working to some extent χ2 (1, n = 1331) = 6.684, p = .035 (Table 1)”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    The overall poor quality of life of the patients in this study, according to the SF-36, was consistent with previously published pain studies but distinctively lower than the Swedish population norm.

    “The overall poor quality of life of the patients in this study, according to the SF-36, was consistent with previously published pain studies [67–69] but distinctively lower than the Swedish population norm [38].”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [67] BS Laursen, 2005, Health related quality of life and quantitative pain measurement in females with chronic non‐malignant pain, European journal of pain source

      Not checked in the free run.

    • cites [68] M Peolsson, 2004, Coping in patients with chronic whiplash-associated disorders: a descriptive study, Journal of rehabilitation medicine source

      Not checked in the free run.

    • cites [69] MK Wallin, 2008, Quality of life in subgroups of individuals with whiplash associated disorders, European Journal of Pain source

      Not checked in the free run.

    • cites [38] M Sullivan, 1995, The Swedish SF-36 Health Survey—I. Evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden, Social science & medicine source

      Not checked in the free run.

  • The quote only partly states this claim.

    Findingown data

    Women expressed being more satisfied with their social life (intimate, private, family and friends) than men.

    “Even though women had pain in several regions (widespread pain, see Table 2) they expressed being more satisfied with their social life (intimate, private, family and friends) and with life in general (Li-Sat11).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Women and men in this study had the same level of pain, the same severity of symptoms, the same discomfort, and the same somatic health.

    “They reported higher activity level (MPI) and activity engagement (CPAQ-8), despite the fact that they have the same level of pain, the same severity of symptoms, the same discomfort and the same somatic health as men.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In some cases, effect sizes were low, indicating that statistically significant differences may not be meaningful.

    “The effect size was in some cases low, which is an indication of that the significance found may not be a meaningful difference.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    More women than men seek rehabilitation.

    “More women than men seek rehabilitation, they present with pain in more body areas, and or widespread pain, while men report having more often localized pain.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    In this study, men were older than women.

    “In the present population, there were fewer men than women born in Sweden were as well as men being older.”
    • Also stated in: § Discussion · plain
      “Among the group of patients in this study, more men were born outside Sweden and they were older than women (Tables 1 and 2).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Women are more sensitive to pain in laboratory settings.

    “Basic research in laboratory environments show that women are more sensitive to pain [14–16]”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [14] KJ Berkley, 1997, Sex differences in pain, Behavioral and Brain Sciences source

      Not checked in the free run.

    • cites [15] RB Fillingim, 1998, Sex differences in temporal summation but not sensory-discriminative processing of thermal pain, Pain source

      Not checked in the free run.

    • cites [16] JL Riley III, 1998, Sex differences in the perception of noxious experimental stimuli: a meta-analysis, Pain source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The TSK has proven to be a reliable assessment tool for chronic pain.

    “The TSK has proven to be a reliable assessment tool for chronic pain [60, 62, 63]”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [60] JW Vlaeyen, 1995, Fear of movement/(re) injury in chronic low back pain and its relation to behavioral performance, Pain source

      Not checked in the free run.

    • cites [62] G Crombez, 1999, Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability, Pain source

      Not checked in the free run.

    • cites [63] MK Lundberg, 2004, A psychometric evaluation of the Tampa Scale for Kinesiophobia—from a physiotherapeutic perspective, Physiotherapy Theory and Practice source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Depression is twice as common in women as in men.

    “Depression is twice as common in women as in men [29].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29] SE Munce, 2007, Gender differences in depression and chronic pain conditions in a national epidemiologic survey, Psychosomatics source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In this study, the Cronbach alpha for MPI was .79.

    “Alpha in the current study was .79.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The SF-36 internal consistency in the Swedish norm is between .79 to .93, comparable to US and UK scales.

    “The internal consistency of the eight scales of the SF-36 in the Swedish norm is between .79 to .93, comparable to US and UK scales [39]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [39] M Sullivan, 2002, SF-36 H? lsoenk? t, Svensk Manual och Tolkningsguide(Swedish Manual and Interpretation Guide)

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Women are more sensitive to both dosage and type of analgesic medication than men.

    “and are more sensitive to both dosage and type of medication [22–24]”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [22] RB Fillingim, 2009, Sex, gender, and pain: a review of recent clinical and experimental findings, The journal of pain source

      Not checked in the free run.

    • cites [23] JE Manson, 2010, Pain: sex differences and implications for treatment, Metabolism source

      Not checked in the free run.

    • cites [24] C Pieh, 2012, Gender differences in outcomes of a multimodal pain management program, Pain source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The EQ-5D has been well-validated across a number of countries, settings and conditions.

    “The EQ-5D has been well-validated across a number of countries, settings and conditions.”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [40] EuroQol Group, 1990, EuroQol—a new facility for the measurement of health-related quality of life, The EuroQol Group. Health Policy source

      Not checked in the free run.

    • cites [41] R Brooks, 1996, EuroQol: the current state of play, Health Policy source

      Not checked in the free run.

    • cites [42] RG Brooks, 1991, EuroQol: health-related quality of life measurement. Results of the Swedish questionnaire exercise, Health Policy source

      Not checked in the free run.

    • cites [43] M Sullivan, 2002, SF-36 hälsoenkät: svensk manual och tolkningsguide (Swedish manual and interpretation guide)

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The TSK factor structure is stable across pain diagnoses and nationalities.

    “the factor structure has been demonstrated to be stable across pain diagnoses and nationalities [64].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [64] J Roelofs, 2007, Fear of movement and (re) injury in chronic musculoskeletal pain: Evidence for an invariant two-factor model of the Tampa Scale for Kinesiophobia across pain diagnoses and Dutch, Swedish, and Canadian samples, Pain source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In this study, the internal consistency of the SF-36 scales was between .70 and .87.

    “in this study the Alpha were between .70 to.87.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    In this study, the internal consistency of the HAD anxiety sub-scale was .77 and the depression subscale was .76.

    “In the current study, the internal consistency of the anxiety sub-scale was .77 and.76 for the depression subscale.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductreasoning

    The significance level was set at p ≤ .01 because of the large sample size, to reduce Type 1 error.

    “Because of the large sample size of the study, stringent p-values were chosen, to reduce the likelihood of Type 1 error. In this study, results that were significant at the p ≤.01 were considered significant”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Ethical approval was obtained from the Regional Ethics Board in Gothenburg (815-12).

    “Ethical approval was obtained from the Regional Ethics Board in Gothenburg (815–12).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The MPI-S has good internal consistency, with a Cronbach's alpha between 0.6 and 0.9.

    “The Swedish version (MPI-S), includes 61 items, has good internal consistency, with a Cronbach’s alpha of between 0.6 and 0.9 [47–50].”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [47] DC Turk, 1987, Towards a comprehensive assessment of chronic pain patients, Behaviour research and therapy source

      Not checked in the free run.

    • cites [48] DC Turk, 1988, Toward an empirically derived taxonomy of chronic pain patients: integration of psychological assessment data, Journal of consulting and clinical psychology source

      Not checked in the free run.

    • cites [49] DC Turk, 1987, Towards a comprehensive assessment of chronic pain patients, Behav Res Ther source

      Not checked in the free run.

    • cites [50] DC Turk, 1988, Toward an empirically derived taxonomy of chronic pain patients: integration of psychological assessment data, J Consult Clin Psychol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The Swedish translation of HADS has shown acceptable psychometric properties.

    “The Swedish translation has shown acceptable psychometric properties [36].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] J Lisspers, 1997, Hospital Anxiety and Depression Scale (HAD): some psychometric data for a Swedish sample, Acta Psychiatrica Scandinavica source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In this study, the Cronbach alpha for EQ-5D was .58.

    “the Cronbach alpha for this study was .58.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Women use more analgesic medication than men.

    “What it is known from clinical studies is that women use more analgesic medication [21]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] RJ Gatchel, 1999, Psychosocial factors in pain: Critical perspectives

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    In this study, the internal consistency of the CPAQ-8 Activity Engagement sub-scale was .88 and Pain Willingness was .74.

    “In the current study, the internal consistency of the AE sub-scale was .88 and .74 for the PW.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductreasoning

    The study used a significance threshold lower than convention and reported effect sizes to address the influence of large sample size.

    “To counteract this, we made the value of p to be accepted as significant to be lower than convention, and we provided effect sizes as a guide to the overall magnitude of effect, uninfluenced by sample size.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Kinesiophobia is a strong predictor for long-term pain disability and pain chronicity, and is associated with higher rates of sick leave, pain vigilance, disability, and decreased physical activity.

    “It has been demonstrated that kinesiophobia has shown to be a strong predictor for pain disability and pain chronicity in the longer term [73] associated with higher rates of sick-leaves [74], pain vigilance and disability as well as decreased physical activity levels [75–77].”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [73] M Grotle, 2010, Are prognostic indicators for poor outcome different for acute and chronic low back pain consulters in primary care?, PAIN® source

      Not checked in the free run.

    • cites [74] TL Symonds, 1995, Absence resulting from low back trouble can be reduced by psychosocial intervention at the work place, Spine source

      Not checked in the free run.

    • cites [75] M Monticone, 2015, Group‐based task‐oriented exercises aimed at managing kinesiophobia improved disability in chronic low back pain, European Journal of Pain

      Not checked in the free run.

    • cites [76] M Monticone, 2014, A multidisciplinary rehabilitation programme improves disability, kinesiophobia and walking ability in subjects with chronic low back pain: results of a randomised controlled pilot study, European Spine Journal source

      Not checked in the free run.

    • cites [77] JW Vlaeyen, 2002, The treatment of fear of movement/(re) injury in chronic low back pain: further evidence on the effectiveness of exposure in vivo, The Clinical journal of pain source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

    Interpretationnone given

    Pain acceptance and kinesiophobia are behaviorally defined and have the potential to be changed.

    “Pain acceptance and kinesiophobia are behaviorally defined and have the potential to be changed.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The Tampa Scale for Kinesiophobia is a valid measure of pain-related fear of movement in Swedish and heterogeneous chronic pain samples.

    “Although initially developed for use with chronic lower back pain patients and later validated in other musculoskeletal pain populations, recent studies suggest that it is a valid measure of pain-related fear of movement in Swedish [63] and for heterogeneous chronic pain samples.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [63] MK Lundberg, 2004, A psychometric evaluation of the Tampa Scale for Kinesiophobia—from a physiotherapeutic perspective, Physiotherapy Theory and Practice source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study's use of self-reports may contain flaws.

    “Another limitation are the potential flaws that self-reports can contain.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    The total group of patients included in this study was representative of a European epidemiological study in terms of age and sex (middle-aged women) and pain duration (>7 years), and of the pain population attending specialty pain care clinics in Sweden.

    “However, the total group of patients included in this study was representative when compared with a European epidemiological study [1] in terms of age and sex (middle-aged women), and pain duration (> 7 years) and with the pain population attending specialty pain care clinics in Sweden [66].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [1] H Breivik, 2006, Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment, European journal of pain source

      Not checked in the free run.

    • cites [66] V Nyberg, 2011, Swedish quality registry for pain rehabilitation: purpose, design, implementation and characteristics of referred patients, Journal of rehabilitation medicine source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    This study indicates differences between men and women regarding symptomatology and their reaction or handling of these.

    “To conclude, this study indicate differences between men and women regarding symptomatology and their reaction or handling these.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    Due to the exploratory and cross-sectional design, no causal inferences can be made and it cannot be established that the found differences influence treatment response.

    “Another limitation in this this study is that due to its exploratory and cross-sectional design, no causal inferences can be made, nor can it be established that the found differences necessarily influence treatment response.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In a previous study, greater positivity among women with chronic pain was linked to greater social support compared to men.

    “This capacity for positivity has also been found in a previous study, where it has been linked to greater social support among women with chronic pain, compared to men [70].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [70] M Löfgren, 2006, ‘A constant struggle’: successful strategies of women in work despite fibromyalgia, Disability and rehabilitation source

      Not checked in the free run.

36 of 36

  • The paper relies on this without support.

    Understanding baseline sex differences in pain-related measures can inform different approaches in rehabilitation.

    “The aim of this study is to explore differences between male and female patients entering a rehabilitation program at a pain clinic in order to gain a greater understanding of different approaches to be used in rehabilitation.”

  • The paper relies on this without support.

    The observed sex differences in pain-related measures are not explained by age differences between men and women.

    “Women were significantly younger than men (Age M = 45 vs. men’s M = 51) t (1367) = -6.52, p < .001, d = .41 (Table 2)”

  • The paper relies on this without support.

    The observed sex differences in activity, pain acceptance, social support, kinesiophobia, and mood are not explained by demographic differences between men and women (e.g., age, birthplace).

    “In the present population, there were fewer men than women born in Sweden were as well as men being older.”
    “These demographic differences may or may not be clinical significant, while differences in how they react and behave while in pain, might have a clinical impact in rehabilitation.”

  • The paper relies on this without support.

    Self-reported measures (e.g., activity level) accurately reflect the actual behavior or state they intend to measure.

    “Another limitation are the potential flaws that self-reports can contain.”
    “This study may have benefited from gathering observational measures, such as physical capacity, activity level, strength, sedentary-time, etc. in order to see how the self-reported activity level correlates with the factual one.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A recent study (n=1371) in the context of a rehabilitation program found that women have better activity level, pain acceptance, and social support, while men report more fear of movement and mood disturbances.

    “A recent study (n=1371) in the context of a rehabilitation program found that women have better activity level, pain acceptance, and social support, while men report more fear of movement and mood disturbances [70].”

    From Tailored web-based interventions for pain: Systematic review and meta-analysis (2017) · cites this paper as [70]

Statistics that don’t add up

Each reported p-value recomputed from its test statistic and degrees of freedom.

  • Inconsistent p-value: t(1109) = 2.78, p = .007

    Minor

    The paper reports p = .007 here; recomputing from the test statistic and its degrees of freedom gives p = .006 (two-tailed). The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .007 · recomputed p = .006

1 of 1

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Doesn’t add upt(1109) = 2.78reported p = .007 · recomputed p = .006

    “t(1109) = 2.78, p = .007”

  • Consistentt(1367) = -6.52reported p < .001 · recomputed p < .001

    “t (1367) = -6.52, p < .001”

  • Consistentt(1212) = 3.31reported p < .001 · recomputed p < .001

    “t (1212) = 3.31, p < .001”

3 of 3

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Physical-functioning p-value differs between results and table

    Major

    The results report p < .001 for physical functioning, whereas Table 3 reports p = .010 for that comparison.

  • Claim of significantly higher social support conflicts with Table 3

    Major

    The abstract and discussion identify higher social support among women as a significant result, but the MPI social-support scores are 4.20 for women and 4.15 for men, with p = .594.

  • Reported share receiving full sickness benefit conflicts with Table 1

    Minor

    The results say one third of participants received full sickness benefit, while Table 1 lists 13.9% receiving 100% sickness benefit and another 5.6% receiving time-limited 100% sickness benefit. Even combined, these categories total only 19.5%.

  • Reported physical-functioning mean difference is incorrect

    Minor

    Table 3 gives physical-functioning means of 49.47 for men and 48.38 for women, a difference of 1.09 rather than the reported 0.20.

    Reported 0.2 · recomputed 1.09

  • Table 3 stars p-values above its stated threshold

    Minor

    The table note defines an asterisk as p ≤ .001, but the mental-health result at p = .007 is starred. The physical-functioning and friends/acquaintances results at p = .010 are starred as well.

  • Work-status p-values are reversed between text and table

    Minor

    The text assigns p = .030 to full-time work and p = .035 to working to some extent. Table 1 assigns those values to the opposite categories.

  • Partner-relationship SD exceeds what its scale permits

    Minor

    On a scale bounded by 1 and 6, a sample with mean 3.70 cannot have an SD as high as 2.76; its maximum possible SD is about 2.49.

7 of 7

Cites

Flagged first, then by citations

2 of the 79 references couldn’t be matched to a known paper.

Research works printed but not linked: 5

  1. BM King, 2010, Point: a call for proper usage of &quot;gender&quot; and &quot;sex&quot; in biomedical publications, Am J Physiol Regul Integr Comp Physiol, 298, R1700, 10.1152/ajpregu.00694.2009 · DOI
  2. AS Zigmond, 1983, The hospital anxiety and depression scale, Acta psychiatrica scandinavica, 67, 361, 10.1111/j.1600-0447.1983.tb09716.x · DOI · Paper page
  3. M Sullivan, 2002, SF-36 H? lsoenk? t, Svensk Manual och Tolkningsguide(Swedish Manual and Interpretation Guide)
  4. AR Fugl-Meyer, 1987, The coping process after traumatic brain injury, Scandinavian journal of rehabilitation medicine Supplement, 17, 51
  5. DC Turk, 1987, Towards a comprehensive assessment of chronic pain patients, Behav Res Ther, 25, 237, 10.1016/0005-7967(87)90002-7 · DOI · Paper page

Cited by

Sorted by citations

Related

Authors
Rovner, G. S., Sunnerhagen, K. S., Björkdahl, A., Gerdle, B., Börsbo, B., Johansson, F., & Gillanders, D.
Affiliations
  • Karolinska Institutet (SE)
  • University of Gothenburg (SE)
  • Linköping University (SE)
  • Danderyds sjukhus (SE)
  • University of Edinburgh (GB)
Corresponding author
Sunnerhagen, Katharina S.
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2017-04-25
Volume
12
Issue
4
Pages
e0175737
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0175737
PMC
PMC5404887
OpenAlex
W2605316699
Semantic Scholar
82ec502d541fb7f49311b5e1f8dc56583b72f893
Cited by
179
References
79
Citations by year
2026: 5 · 2025: 13 · 2024: 25 · 2023: 24 · 2022: 27 · 2021: 24 · 2020: 11 · 2019: 34 · 2018: 12 · 2017: 4
FWCI
11.65
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
Funders
  • Vårdalstiftelsen
  • AFA Försäkring
  • Sveriges Kommuner och Landsting
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
Keywords
chronic pain, sex differences, pain acceptance, kinesiophobia, pain rehabilitation, anxiety, depression, quality of life, social support, activity level
MeSH terms
Adult, Affect, Anxiety, Behavior, Depression, Female, Humans, Male, Middle Aged, Pain Measurement, Psychometrics, Quality of Life, Surveys and Questionnaires, Sex Characteristics, Sex Factors, Social Support, Chronic Pain

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review