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. 2020 Mar 4:8:e8643.
doi: 10.7717/peerj.8643. eCollection 2020.

Let's talk about pain catastrophizing measures: an item content analysis

Geert Crombez  1 , Annick L De Paepe  1 , Elke Veirman  1 , Christopher Eccleston  2 , Gregory Verleysen  3 , Dimitri M L Van Ryckeghem  1   4   5
Affiliations

Let's talk about pain catastrophizing measures: an item content analysis

Geert Crombez et al. PeerJ. .

Abstract

Background: Concerns have been raised about whether self-report measures of pain catastrophizing reflect the construct as defined in the cognitive-behavioral literature. We investigated the content of these self-report measures; that is, whether items assess the construct 'pain catastrophizing' and not other theoretical constructs (i.e., related constructs or pain outcomes) using the discriminant content validity method.

Method: Items (n = 58) of six pain catastrophizing measures were complemented with items (n = 34) from questionnaires measuring pain-related worrying, vigilance, pain severity, distress, and disability. Via an online survey, 94 participants rated to what extent each item was relevant for assessing pain catastrophizing, defined as "to view or present pain or pain-related problems as considerably worse than they actually are" and other relevant constructs (pain-related worrying, vigilance, pain severity, distress, and disability).

Results: Data were analyzed using Bayesian hierarchical models. The results revealed that the items from pain-related worrying, vigilance, pain severity, distress, and disability questionnaires were distinctively related to their respective constructs. This was not observed for the items from the pain catastrophizing questionnaires. The content of the pain catastrophizing measures was equally well, or even better, captured by pain-related worrying or pain-related distress.

Conclusion: Based upon current findings, a recommendation may be to develop a novel pain catastrophizing questionnaire. However, we argue that pain catastrophizing cannot be assessed by self-report questionnaires. Pain catastrophizing requires contextual information, and expert judgment, which cannot be provided by self-report questionnaires. We argue for a person-centered approach, and propose to rename 'pain catastrophizing' measures in line with what is better measured: 'pain-related worrying'.

Keywords: Catastrophizing; Content validity; Pain; Questionnaires; Validity; Worrying.

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Conflict of interest statement

The authors declare there are no competing interests.

Figures

Figure 1
Figure 1. Estimates and associated 95% credibility intervals (CI) of the relevance score for the PCI (worry about pain), PVAQ (pain vigilance) and MPI (affective distress; disability; pain severity) on each construct.
The estimate and CI for the construct each measure is designed to assess is indicated in black. The estimate and CI for the other constructs is depicted in grey. Included scales were (subscales of) the (A) PCI (Pain Cognitions Inventory), (B) PVAQ (Pain Vigilance and Awareness Questionnaire), (C) MPI - affective distress (Multidimensional Pain Inventory), (D) MPI - disability (Multidimensional Pain Inventory). (E) MPI - pain severity (Multidimensional Pain Inventory).
Figure 2
Figure 2. Estimates and associated 95% credibility intervals of the relevance score for each of the six pain catastrophizing measures on pain catastrophizing.
The six pain catastrophizing measures were (subscales of) the AEQ (Avoidance Endurance Questionnaire), CSQ (Coping Strategies Questionnaire), CCSI (Cognitive Coping Strategies Inventory), PCS (Pain Catastrophizing Scale), PCL (Pain Cognition List), and PRSS (Pain-Related Self-Statements Scale).
Figure 3
Figure 3. Estimates and associated 95% credibility intervals of the relevance score for each of the six pain catastrophizing measures on each construct.
The estimate and CI for the construct each measure is designed to assess is indicated in black. The estimate and CI for the other constructs is depicted in grey. The six pain catastrophizing measures were (subscales of) the (A) AEQ (Avoidance Endurance Questionnaire), (B) CSQ (Coping Strategies Questionnaire), (C) CCSI (Cognitive Coping Strategies Inventory), (D) PCL (Pain Cognition List), (E) PCS (Pain Catastrophizing Scale), and (F) PRSS (Pain-Related Self-Statements Scale).
See this image and copyright information in PMC

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