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

Geert Crombez,Elke Veirman,Annick L De Paepe,Christopher Eccleston,Gregory Verleysen,Dimitri M L Van Ryckeghem

doi:10.7717/peerj.8643

Geert Crombez, Elke Veirman + Show 4 more

Open Access

https://doi.org/10.7717/peerj.8643

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Abstract

BackgroundConcerns 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.MethodItems (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).ResultsData 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.ConclusionBased 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’.

Highlights

Pain catastrophizing, broadly conceived as an exaggerated mental set brought to bear during painful experiences (Sullivan et al, 2001), has emerged as one of the most important psychosocial predictors of pain, distress, and disability (Edwards et al, 2011; Keefe et al, 2004; Quartana, Campbell & Edwards, 2009)
We investigated to what extent items from pain catastrophizing measures are (a) relevant for the construct ‘pain catastrophizing’, and (b) distinct from related constructs (i.e., ‘worrying about pain’, ‘pain vigilance’), and primary outcomes (i.e., ‘pain severity’, ‘pain-related distress’, and ‘painrelated disability’)
One participant failed to respond correctly on the IMC items, 36 participants provided unreliable data, two participants stated that English was not their first language, four participants completed the questionnaire in less than 15 min, and one participant indicated at the end of the questionnaire that his/her data should not be used

Summary

Introduction

Broadly conceived as an exaggerated mental set brought to bear during painful experiences (Sullivan et al, 2001), has emerged as one of the most important psychosocial predictors of pain, distress, and disability (Edwards et al, 2011; Keefe et al, 2004; Quartana, Campbell & Edwards, 2009). 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. 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 are’’ and other relevant constructs (pain-related worrying, vigilance, pain severity, distress, and disability). 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. We argue for a person-centered approach, and propose to rename ‘pain catastrophizing’ measures in line with what is better measured: ‘pain-related worrying’

Results

Discussion

Conclusion