The Pain Catastrophizing Scale-short form: psychometric properties and threshold for identifying high-risk individuals

Abstract

Objective: The Pain Catastrophizing Scale (PCS) measures three aspects of catastrophic cognitions about pain-rumination, magnification, and helplessness. To facilitate assessment and clinical application, we aimed to (a) develop a short version on the basis of its factorial structure and the items' correlations with key pain-related outcomes, and (b) identify the threshold on the short form indicative of risk for depression.

Design: Cross-sectional survey.

Setting: Social centers for older people.

Participants: 664 Chinese older adults with chronic pain.

Measurements: Besides the PCS, pain intensity, pain disability, and depressive symptoms were assessed.

Results: For the full scale, confirmatory factor analysis showed that the hypothesized 3-factor model fit the data moderately well. On the basis of the factor loadings, two items were selected from each of the three dimensions. An additional item significantly associated with pain disability and depressive symptoms, over and above these six items, was identified through regression analyses. A short-PCS composed of seven items was formed, which correlated at r=0.97 with the full scale. Subsequently, receiver operating characteristic (ROC) curves were plotted against clinically significant depressive symptoms, defined as a score of ≥12 on a 10-item version of the Center for Epidemiologic Studies-Depression Scale. This analysis showed a score of ≥7 to be the optimal cutoff for the short-PCS, with sensitivity = 81.6% and specificity = 78.3% when predicting clinically significant depressive symptoms.

Conclusions: The short-PCS may be used in lieu of the full scale and as a brief screen to identify individuals with serious catastrophizing.

Keywords: chronic pain; depressive symptoms; older adults; pain catastrophizing.