The ability of three new methods of scoring the Pain Drawing to predict psychological distress in two cohorts of 100 patients with chronic low back pain was investigated. Patients completed a Pain Drawing and questionnaire measures of psychological distress and were given a standard physical examination. The two cohorts were significantly different on all variables (except for disability). The relationship between the three new scoring systems and measures of distress, physical factors, and disability was investigated. The new scoring methods had high reliability. Pain Sites was a more accurate predictor of distress, but was unable to do so with sufficient specificity/sensitivity. Body Map did not correlate with physical/disability measures. Using the new scoring systems, it was not possible to identify distressed patients with sufficient sensitivity/specificity, nor to differentiate between organic and nonorganic pain patterns.