Trait emotional intelligence and disability in chronic low back pain: associations with depressive symptoms and physical functioning

Background We examined the patterns of associations of disability and trait emotional intelligence with physical functioning and depressive symptoms in chronic low back pain. Materials and methods Adults presenting with low back pain were recruited consecutively at a single physical medicine and rehabilitation outpatient clinic. Of 153 eligible patients approached, 13 declined and 140 enrolled. This secondary complete-case analysis retained participants reporting pain for more than 3 months; 23 participants with pain lasting 3 months or less and 5 with incomplete core-scale data were excluded, leaving n = 112. Spearman correlations were evaluated within defined false discovery rate families; multivariable models used heteroscedasticity-consistent covariance estimator 3 (HC3) standard errors, and exploratory cross-sectional indirect associations used 10,000 bootstrap resamples to estimate percentile confidence intervals. The chronic-subgroup restriction, hypotheses, and three multivariable model specifications were prespecified within the secondary-analysis workflow. Results Mean age was 47.60 ± 14.57 years and 64.3% were women. Activity pain was associated with greater Oswestry disability ( ρ = 0.427; q < 0.001), and disability was associated with lower physical functioning (ρ = −0.495; q < 0.001). Trait emotional intelligence demonstrated a modest inverse association with depressive symptoms (ρ = −0.247; q = 0.019) and a low positive bivariate association with physical functioning (ρ = 0.241; q = 0.020); no statistically significant associations with rest pain, activity pain, or disability were detected in this sample. In the depressive-symptom model, higher trait emotional intelligence was associated with lower Beck Depression Inventory score after adjustment for age, sex, body mass index, activity pain, and disability ( B = −0.138; β = −0.255; 95% HC3 confidence interval [CI], −0.253 to −0.022; p = 0.020), corresponding to approximately 1.38 points lower Beck Depression Inventory (BDI) per 10-point increase in the trait emotional intelligence score. The 10,000-resample bootstrap confidence interval for the coefficient excluded zero. The full model explained 9.4% of variance, and its HC3 robust omnibus test was not significant ( p = 0.115); median quantile regression retained the negative direction but did not reach statistical significance. The physical-functioning association attenuated after adjustment ( B = 0.204; p = 0.132). The exploratory cross-sectional indirect association of activity pain with physical functioning through Oswestry disability was −0.795 (95% percentile bootstrap CI, −1.525 to −0.267). Conclusion The data indicated a cross-sectional pattern in which activity-related pain was associated with greater disability and poorer physical functioning, whereas higher trait emotional intelligence demonstrated a modest inverse association with depressive symptoms. No statistically significant associations of trait emotional intelligence with pain or disability were detected in this sample. The emotional intelligence finding represents a modest adjusted cross-sectional association in the context of low explained variance, uncertainty under the alternative median quantile-regression model, measurement limitations, and potential residual confounding. Cross-sectional data do not establish temporal or causal pathways.