Date of Award


Document Type

Doctoral Research Project

Degree Name

Doctor of Psychology (PsyD)



First Advisor

Vida L. Tyc

Second Advisor

Anthony LoGalbo

Third Advisor

Jignya Patel

Fourth Advisor

Robert A. Taylor


Chronic pain patients are more likely to use healthcare services and have greater expenditures related to health needs, which has led to studies on different aspects of pain that may lead to greater use, disability, functional impairment, and other outcomes. Factors that have been researched for their potential relationships with healthcare utilization (HCU) in various populations include function loss, pain catastrophizing, anxiety, fear, pain severity, and pain duration. Pain tolerance has not been extensively studied for its impact on healthcare utilization among patients with chronic pain. This study examined the relationship between perceived pain tolerance in chronic pain patients and their healthcare utilization, as well as use of substances such as alcohol, tobacco, and illicit drugs. The impact of barriers to seeking treatment on these associations was also examined. The relationship between pain tolerance and other pain characteristics (i.e., severity, duration), degree of functional impairment, and demographic variables, was also assessed. Results from this study demonstrated that patients with a lower perception of pain tolerance were more likely to have higher healthcare utilization than those with higher perceptions of pain tolerance, regardless of their barriers to treatment.

Perceived pain tolerance was also lower in those who sought more frequent treatment and rated their pain as more severe, suggesting that perceived pain tolerance is an important factor to consider in the assessment of pain. Additionally, individuals with higher substance use risk had lower perceived pain tolerance compared to lower risk participants. This study provided a better understanding of the relevance of perceived pain tolerance among patients with chronic pain and may help inform interventions that can help to reduce patients’ pain and more optimally guide their car


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