(348) Confirmatory factor analysis of the Pain Catastrophizing Scale in African Americans with pain in a primary care setting

Abstract

Pain catastrophizing is frequently cited in studies of patients with pain as a contributing factor to poor coping, disability, distress, and increased pain levels. The Pain Catastrophizing Scale is the most commonly used instrument to measure this construct. The factor structure of the Pain Catastrophizing Scale has been identified in primarily Caucasian samples as having 3 factors: Rumination, Magnification, and Helplessness. Recently, it has been suggested that there may be only 2 factors (Rumination and “Powerlessness”) in an African American Workman’s Compensation sample. 1 The factor structure has not been examined in an African American sample in the primary care setting. This study used confirmatory factor analysis to explore the factor structure in African Americans (n 278) with pain in an urban primary care setting for indigent adults. Patients were 53% male, 56% had a high school education or better, 54% were single, and 73% were not working, primarily due to pain. Results supported the original 3-factor model of Rumination, Magnification, and Helplessness with RMSEA and CFI indices of 0.62 and .957, respectively. Correlations among the three latent factors were high ranging from .80 to .89. Internal consistencies (Cronbach’s alpha) within each factor were also high at .85 for Helplessness, .73 for Magnification, and .75 for Rumination. Standard path coefficients for individualized items ranged from .60-.81 for Helplessness, from .64 to .75 for Magnification, and from .32 to .84 for Rumination. As frequency of using the Pain Catastrophizing Scale to determine patients’ responses to pain increases, it is important to determine differences in specific populations. Testing of this instrument on various ethnic groups, genders, and pain types will increase the understanding of the results and improve the usefulness of the instrument. Supported by a grant from the Detroit Medical Center/Wayne State University College of Nursing Scholars Award. (1. Chibnall, Pain, 2005.)