The present study sought to identify psychological variables capable of forecasting both the pursuit of treatment and the degree of disability experienced across the full span of chronic back pain. A total of 201 adults suffering from ongoing back pain were enlisted with assistance from healthcare providers. These individuals completed several standardized instruments: the Depression, Anxiety, and Stress Scale (DASS), the Oswestry Back Pain Disability Questionnaire (ODQ), the McGill Pain Questionnaire (MPQ), and the life control plus affective distress components drawn from the West Haven–Yale Multidimensional Pain Inventory (WHYMP). They further reported how many treatment sessions they had attended throughout the entire duration of their condition. The analysis tested depression, life control, and affective distress as indirect influences on the severity of disability, with the number of treatment sessions serving as the mediating factor. Results showed that every single-unit improvement in life control corresponded to nearly 30 extra treatment sessions attended, whereas every single-unit increase in affective distress was linked to 16 fewer sessions, and every single-unit rise in depression predicted 4 fewer sessions. Collectively, these factors accounted for 44% of the variation observed in treatment-seeking behavior. The influence of life control and affective distress on disability was entirely channeled through treatment attendance; in contrast, depression maintained an independent direct impact on disability. Treatment attendance itself exerted a notable effect on disability outcomes. In summary, individuals displaying reduced life control together with heightened affective distress and depression reported more intense pain and greater disability. This outcome stemmed partly from their distinctive patterns of seeking treatment.
