One psychological issue associated with pain and other health outcomes is psychological distress. The concept of distress is a broad label given to a variety of states and responses, most commonly those related to depression and anxiety [17,18]. As a construct, distress is positively related to both poor mental health and clinical psychological disorders, thereby making it an excellent general measure. A survey of large Australian companies found that 4.5% of full-time employees experience high levels of psychological distress in any given month [19]. This finding is significant as distress is associated with decreased work ability [20], and it appears that the majority of distressed employees are not receiving treatment (i.e., psychological counseling) [19]. Understanding the interaction between physical pain, injury, and psychological distress is therefore critical in organizational settings. A large survey of patient-care workers demonstrated significantly higher distress among workers who reported pain in the past 3 months than those who did not report pain [21]. In addition, pain intensity, number of bodily areas in which pain was experienced, psychological distress, and higher age were each independently associated with pain interference in work, suggesting that the combination of pain and distress may have particular significance for presenteeism.