Bath Adolescent Pain Questionnaire Research Articles

Psychometric evaluation of an Icelandic translation of the adolescent and parent report versions of the BATH pain questionnaires and investigation of the psychosocial impact of pain on adolescents with chronic disease.

Adolescents commonly experience chronic pain, which can have considerable multidimensional effects on their lives, impacting, for example, their school functioning, leisure activities, sleep, and emotional functioning. Therefore, valid and reliable measurements of these multidimensional and potentially adverse effects, reflecting both the adolescents' and parents' perceptions, are essential. At present, no such measures are available in Iceland. The primary aim of the current study was to translate the Bath Adolescent Pain Questionnaire (BAPQ) and the Bath Adolescent Pain Questionnaire parent version (BAPQ-P) and evaluate the psychometric qualities of the Icelandic translation. The study's secondary aim was to investigate the multidimensional impact of chronic pain on adolescents with chronic illness using these instruments. Participants were 45 adolescents (11-16 years old) registered in the medical records of the National University Hospital of Iceland with one of the following diagnoses: (1) Crohn's or colitis (IBD); (2) migraine; or (3) arthritis. Sixty-nine parents of the diagnosed adolescents also participated (a total of 41 adolescent and parent dyads). To establish the psychometric qualities of the BAPQ and BAPQ-P, participants were asked to complete several questionnaires online. The preliminary results showed that the Icelandic translations of the BAPQ and BAPQ-P scales have good psychometric qualities, providing valid and reliable measures to assess the multidimensional effects of chronic pain in adolescents in both clinical and research settings. Moreover, the results showed that chronic pain impacts various domains in the adolescents' lives and that the prevalence of anxiety and depression was quite high among them.

Routine use of the Bath Adolescent Pain Questionnaire in a paediatric pain clinic.

Assessment of outcomes from health interventions are of increasing importance, primarily to identify effective and safe treatment, but also to justify funding decisions. The Bath Adolescent Pain Questionnaire (BAPQ) is a self-report questionnaire, validated in 11-18 year olds, assessing the impact of pain in multiple domains of adolescent life. The similarly validated Bath Adolescent Pain Questionnaire for Parents (BAPQ-P) uses the same domains as the BAPQ, assessing the functioning and development of the adolescent from the parents' perspective. We conducted a prospective study, planning to routinely collect BAPQ/BAPQ-P data at initial assessment and 6 months later. All patients aged between 5 and 19 attending our chronic pain clinic for the first time between December 2009 and December 2014 were mailed BAPQ and BAPQ-P questionnaires before the first appointment and 6 months after the first appointment. In total, 376 of 386 families returned questionnaires at time 0 and 96 after 6 months, 26% of those responded at time 0. We found statistically significant differences on patients' BAPQ questionnaires from 0 to 6 months showing improvement in all domains. A different result was found on parents' questionnaires where we only found a statistically significant difference on daily and emotional functioning. When comparing patient and parent questionnaires at 0 and 6 months, we found statistically significant differences between patients' and parents' questionnaires in the daily functioning and development domains. We believe BAPQ and BAPQ-P measurement proved useful tools to assess response to pain management input in adolescents over a 6-month period. Our experience and results suggest that these tools can, with appropriate administrative support, be used in routine clinical practice to assess patient outcomes. We also believe that BAPQ and BAPQ-P measurements have a utility to audit pain clinic activity and potentially a use in demonstrating beneficial outcomes to commissioners.

A usability and feasibility study of a computerized version of the Bath Adolescent Pain Questionnaire: the BAPQ-C

BackgroundPain is a common experience in adolescence, with up to 44% of adolescents reporting chronic pain. For a significant minority, severe pain becomes an ongoing disabling problem. Treatment of adolescent chronic pain aims to reduce the impact of pain on adolescents’ lives. Efficient, accurate assessment of the impact of pain is essential to treatment. The ‘Bath Adolescent Pain Questionnaire’ (BAPQ) is a psychometrically robust multidimensional self-report measure of adolescent functioning. Whilst widely used, the paper-based format of the BAPQ can present completion difficulties for adolescents experiencing chronic pain. To increase the accessibility and clinical utility of the BAPQ, an electronic version of the measure is needed. This study assesses the usability and feasibility of a computerized version of this measure (BAPQ-C) in an adolescent chronic pain population.MethodsFourteen adolescents (13 females; 13–16 years) were recruited from a hospital-based residential pain management programme. Participants completed a qualitative ‘thinking aloud task’ whilst completing the BAPQ-C. and, an acceptability questionnaire regarding the BAPQ-C. Data were analysed using thematic analysis, a widely used qualitative method of data analysis .ResultsTwo themes labelled ‘engagement and technological appeal’ and ‘accessibility and independence’ were generated. Themes revealed numerous factors contributing to participants’ preference for the BAPQ-C compared with the paper version of the BAPQ. Participants reported that the BAPQ-C was ‘quicker’ and ‘easier’ to complete than the BAPQ. Functional aspects of the BAPQ-C which included use of a touch screen rather than a pen and paper, font colours/styles, the zoom function and the spellchecker, provided participants with improved access. This subsequently increased participants’ independence and confidence when completing the measure.ConclusionThe BAPQ-C is a feasible multidimensional tool for the assessment of functioning in adolescents who experience chronic pain. It was well-received by participants who were able to complete the measure more quickly, independently and confidently than the paper-based BAPQ. Increased speed, ease and accuracy of completion make the BAPQ-C an ideal tool for use in busy clinical and research settings. Findings highlight the potential benefits of adopting the BAPQ-C when assessing the impact of chronic pain on adolescents in clinic and home-based settings.

Interdisciplinary Pain Management Improves Pain and Function in Pediatric Patients with Chronic Pain Associated with Joint Hypermobility Syndrome.

The relation between chronic musculoskeletal pain and joint hypermobility in a small percentage of the pediatric population is well described. However, literature discussing the treatment of chronic pain associated with joint hypermobility in pediatrics is limited. The present study examines the impact of interdisciplinary treatment on chronic pain in pediatrics with joint hypermobility syndrome. To determine if pediatric patients with chronic pain related to joint hypermobility can be effectively treated with an intensive, interdisciplinary pain management program, as measured by changes in pain, psychosocial and physical functioning, as well as parental coping. Retrospective cohort study. Urban academic tertiary intensive outpatient interdisciplinary pain management clinic. The study involved 30 patients who met the criteria for a diagnosis of joint hypermobility and chronic pain and completed an interdisciplinary pain management program. All patients were treated in an intensive pediatric interdisciplinary pain management program for a duration of 6 to 8 weeks. The program provided physical therapy, occupational therapy, psychological counseling, and weekly pediatric rehabilitation medicine follow-up. Outcome measures included numeric rating scale pain scores, the Bath Adolescent Pain Questionnaire, and the Bath Adolescent Pain-Parent Impact Questionnaire. Changes from pre- to post-treatment were analyzed using paired-samples t tests. Patients endorsed pre- to post-treatment improvements in pain, depression, general anxiety, pain-related anxiety, social functioning, and physical functioning (P < .05). The patients' parents showed significant improvements in depression, anxiety, catastrophic thinking, self-blame and helplessness, leisure functioning, and parental behavior (P < .05). The present findings suggest that an intensive interdisciplinary rehabilitation pain management program yields short-term improvements in pain, emotional and physical function, and daily activity in a pediatric population diagnosed with joint hypermobility. Parents also experienced benefits from the program. A larger prospective study with longer-term follow-up is needed. III.

Sensory Modulation: An Important Piece of the Disability Puzzle for Adolescents With Persistent Pain.

Sensory modulation patterns contribute to altered pain perception and disengagement in activities; atypical sensory modulation patterns have been associated with higher pain sensitivity, catastrophizing, and reduced function. Objectives of this study were to ascertain whether: adolescents with persistent pain had atypical sensory modulation patterns, atypical sensory modulation was associated with reduced functioning and higher pain, and pain catastrophizing mediated the relationship between sensory modulation and functional disability. Adolescents (N=70, females=63, males=7) attending tertiary level interdisciplinary team assessment for persistent pain completed sensory modulation (Adolescent/Adult Sensory Profile), pain catastrophizing (Bath Adolescent Pain Questionnaire), pain intensity, functional disability (Functional Disability Index), and quality of life (QOL) (Pediatric QOL Scales) questionnaires. Adolescents with persistent pain had atypical patterns of sensory modulation compared with normative data. Sensory modulation patterns were not associated with pain intensity; however, higher sensitivity was associated with greater disability (r=0.36, P<0.01), and lower registration of sensation was associated with poorer emotional (r=0.31, P<0.01), social (r=0.35, P<0.01), and school-related (r=0.49, P<0.001) QOL. Sensory modulation, pain intensity, and catastrophizing contributed independently to disability; catastrophizing mediated sensory sensitivity and both functional disability and emotional QOL. This study is the first to show that atypical sensory modulation patterns are associated with poorer function for adolescents with persistent pain, suggesting that individualized sensory-informed interventions can potentially facilitate participation in daily activities and improve QOL.

(197) - Change in adolescent and parental emotional behavior determines long-term outcomes for adolescents with chronic pain following interdisciplinary pain management program

Chronic pain in adolescents is a serious issue that can lead to decreased social interactions, school absences, and impaired academic performance. In addition to physiologic, psychologic, and social factors, parental anxiety is believed to contribute to the development and maintenance of chronic pain. Retrospectively, we examined the charts of 144 patients, ages 8–18, with various chronic pain conditions and placed them into one of six diagnostic groups: complex regional pain syndrome, abdominal pain, back pain, hypermobility, headache, and fibromyalgia. Data was acquired from patient charts at baseline, post-treatment, and long-term follow-up (one to two months after treatment). We analyzed the course of the adolescent's recovery during an interdisciplinary pain management program and assessed the adolescent's and parent's functioning using the Bath Adolescent Pain Questionnaire and Bath Adolescent Pain-Parental Impact Questionnaire. At baseline, adolescents from all diagnostic groups presented with similar pain intensity and functional scores, and all parents exhibited similar scores on the BAP-PIQ. Following treatment, all adolescents and their parents, regardless of diagnosis, showed significant improvements in pain and emotional functioning, but improvements in pain and emotional function showed little correlation with each other. Future physical and emotional outcomes were predicted by changes in parental self-blame and adolescent emotion during treatment with 84% success rate. We believe chronic pain treatment in adolescents should target these specific components. Effectively treating the child's depression or anxiety and involving parents in therapy to decrease their level of self-blame and can improve long-term outcomes for the patient.

The influence of anxiety reduction on clinical response to pediatric chronic pain rehabilitation.

This study investigates the relationship between anxiety reduction and functional outcomes in children and adolescents receiving intensive interdisciplinary rehabilitation services for chronic pain (CP). Specifically, we evaluated whether: (1) anxiety changes over the course of treatment; (2) anxiety covaries with functional outcomes to rehabilitation; and (3) change in anxiety predicts change in functional outcomes from rehabilitation for CP. Using 3 separate measures assessing anxiety-related constructs, we hypothesized that anxiety would be associated with functioning, both before and following intensive rehabilitation for CP. Further, we hypothesized that a decrease in anxiety-related symptoms following rehabilitation would predict a positive change in functional outcomes. Our sample consisted of 119 children and adolescents treated for CP in an interdisciplinary rehabilitation program between 2007 and 2012. Children completed 3 measures related to anxiety (general anxiety, pain-specific anxiety, pain catastrophizing) and 2 functional outcome measures (eg, Bath Adolescent Pain Questionnaire, PedsQL) as part of clinical care. Measures of anxiety-related constructs were significantly correlated with measures of impairment and functioning, both at admission and at 1-month postdischarge. Regression analyses demonstrated that, after controlling for age, sex, and pain level at admission, a decrease in anxiety significantly predicted between 14% and 40% unique variance in functional outcomes. The findings of this study support existing research on anxiety and CP, specifically the relationship between anxiety and pain-related disability. This study also supports the benefit of intensive interdisciplinary rehabilitation for both reducing anxiety and increasing functional outcomes, suggesting a possible link in children's response to intervention. Study limitations and future directions for related research are discussed.

(546) Treatment of pediatric chronic pain associated with joint hypermobility in an interdisciplinary pain management program

Chronic pain is common in individuals with joint hypermobility syndromes, but effective treatment options are poorly described. Intensive interdisciplinary pain management programs, incorporating medication management, pain psychology, biofeedback, physical and occupational therapy are effective for the treatment of multiple chronic pain conditions. We aimed to determine if such a program can improve pain and function in pediatric patients with chronic pain related to joint hypermobility. This retrospective cohort study included patients less than 18 years of age diagnosed with a joint hypermobility syndrome and chronic pain, who were treated in an intensive 6-week program at an interdisciplinary pain management center. Outcomes measured included Numeric Rating Scale (NRS) pain scores, Bath Adolescent Pain Questionnaire (BAPQ), Child Functional Disability Index (C-FDI) and Parent Functional Disability Index (P-FDI). Changes from admission to discharge were compared by Wilcoxon rank-sum test and assessed for clinical significance according to Cochrane Review criteria for treatment of chronic pain. Eleven female patients, mean age of 14.6, standard deviation (SD) 2.2 years (ranging 9-17), were included. From admission to discharge, average NRS scores significantly decreased for typical pain (p = 0.08) and greatest daily pain (p = 0.03). Patients showed significant improvement in the daily functioning as measured by the BAPQ (p = 0.04). The mean magnitude of change was 2.6 (SD 2.2), 2.5 (SD 3.0), and 4.5 (SD 6.6) for the decrease in typical pain, decrease in greatest pain, and improvement in daily functioning, respectively, representing clinically improvement for each of these outcome measures. Improvements on the C-FDI, P-FDI, and the emotion domain of the BAP-Q were nonsignificant (p’s >.05). Our findings suggest that an intensive interdisciplinary pain management program results in improvements in pain and functional scores that are both statistically and clinically significant. Chronic pain is common in individuals with joint hypermobility syndromes, but effective treatment options are poorly described. Intensive interdisciplinary pain management programs, incorporating medication management, pain psychology, biofeedback, physical and occupational therapy are effective for the treatment of multiple chronic pain conditions. We aimed to determine if such a program can improve pain and function in pediatric patients with chronic pain related to joint hypermobility. This retrospective cohort study included patients less than 18 years of age diagnosed with a joint hypermobility syndrome and chronic pain, who were treated in an intensive 6-week program at an interdisciplinary pain management center. Outcomes measured included Numeric Rating Scale (NRS) pain scores, Bath Adolescent Pain Questionnaire (BAPQ), Child Functional Disability Index (C-FDI) and Parent Functional Disability Index (P-FDI). Changes from admission to discharge were compared by Wilcoxon rank-sum test and assessed for clinical significance according to Cochrane Review criteria for treatment of chronic pain. Eleven female patients, mean age of 14.6, standard deviation (SD) 2.2 years (ranging 9-17), were included. From admission to discharge, average NRS scores significantly decreased for typical pain (p = 0.08) and greatest daily pain (p = 0.03). Patients showed significant improvement in the daily functioning as measured by the BAPQ (p = 0.04). The mean magnitude of change was 2.6 (SD 2.2), 2.5 (SD 3.0), and 4.5 (SD 6.6) for the decrease in typical pain, decrease in greatest pain, and improvement in daily functioning, respectively, representing clinically improvement for each of these outcome measures. Improvements on the C-FDI, P-FDI, and the emotion domain of the BAP-Q were nonsignificant (p’s >.05). Our findings suggest that an intensive interdisciplinary pain management program results in improvements in pain and functional scores that are both statistically and clinically significant.

Physical and social functioning in adolescents with rheumatological conditions: a study of predictors

This study examines possible predictors of physical and social functioning in adolescents with rheumatological conditions. Condition-related variables and psychosocial variables were studied, and their relative contribution as predictors was examined. The study population was one hundred and twelve adolescents (11-18years) attending secondary and tertiary paediatric rheumatology outpatient clinics in south-west England. These adolescents completed validated self-report accounts of disease history, pain and functioning (condition-related variables) and the Bath Adolescent Pain Questionnaire (psychosocial variables). Correlation and regression analyses were used to establish influences on physical and social functioning, examining condition-related variables and psychosocial variables as separate blocks. Physical functioning was independently associated with age at onset, intensity of pain, presence of depression and pain-specific anxiety. Social functioning was only associated with general anxiety. The presence of an inflammatory diagnosis had no bearing on optimal functioning in this study. Condition-related variables (age at onset, pain intensity) and psychosocial variables (depression, pain-specific anxiety) were equally important for physical functioning, whereas psychosocial variables (general anxiety) were more influential for social functioning. Understanding the impact of disease and associated variables in the adolescent rheumatology population should optimize targeted multidisciplinary rehabilitation for the young person and their family.

Pain-related fears in children and adolescents with chronic pain and their parents: mechanism of change and implications for treatment

Pain-related fears in children and adolescents with chronic pain and their parents: mechanism of change and implications for treatment

Psychometric evaluation of the Bath Adolescent Pain Questionnaire (BAPQ) in a US–based clinical population

The Bath Adolescent Pain Questionnaire (BAPQ) was developed as a comprehensive tool for assessing adolescents who experience chronic pain. Psychometric properties have been evaluated and established among an English sample of adolescents experiencing pain. In the present study we sought to evaluate whether or not similar psychometric properties would be obtained from a US-based clinical population. Data from a sample of 110 consecutive children and adolescents presenting for evaluation of their chronic pain at an urban interdisciplinary pain management program (71% female; M Age=14.6, range 8-18 (5 under 11), SD=2.3) was examined in this retrospective chart review.

Toward a taxonomy of adolescents with chronic pain: Exploratory cluster and discriminant analyses of the bath adolescent pain questionnaire

Emerging evidence has indicated that adolescent chronic pain is a significant healthcare issue, the impact of which is determined by a complex interplay of biological, emotional, social, and familial factors. Recently, progress has been made in assessment of pain and functioning in adolescents with chronic pain. A next step is to evaluate whether discrete subgroups of patients exist and whether assessment measures can be used to determine subgroup membership for individual pain sufferers. The present study sought to address these two issues. A battery of questionnaires, including the bath adolescent pain questionnaire, was completed by 209 adolescents with chronic pain presenting for an assessment appointment. Results from cluster analyses indicated the presence of four distinct subgroups. Three clusters differed from one another along a single continuum of severity and the fourth was characterized by good family cohesion, moderate emotional difficulties, and significant difficulties with physical functioning. Follow-up analyses indicated significant differences among the clusters across eight of nine measures of functioning including pain intensity, healthcare utilization, school attendance, amount of weekly exercise, depression, disability, social functioning, and catastrophic thinking. A discriminant analysis was able to correctly classify over 95% of participants into the correct cluster. These results provide strong support for the derived four cluster solution, which may be useful in both clinical and research settings, as it allows for individual adolescent pain sufferers to be classified into groupings according to the severity and type of difficulties being experienced.

Toward a taxonomy of adolescents with chronic pain: cluster and discriminant analyses of the Bath Adolescent Pain Questionnaire

Toward a taxonomy of adolescents with chronic pain: cluster and discriminant analyses of the Bath Adolescent Pain Questionnaire

(357) A review of the current status of measurement of the impact of adolescent chronic pain

Chronic pain has widespread deleterious effect on the lives of adolescents and their parents, affecting physical, psychological social and familial functioning. Measurement of these effects is an important clinical and scientific starting point for both research and clinical practice. This study reports on two reviews of existing measures for adolescents with chronic pain and their parents, in addition to the development and use of two multidimensional measures designed for use with these particular populations. Separate systematic literature searches were conducted to identify measures used specifically to assess functioning of adolescents with chronic pain and their parents. The adolescent review identified a total of 43 measures used with adolescents, whilst the parent review identified a total of 68 measures used with parents of adolescents with chronic pain. Further examination revealed a dearth of measures designed specifically for adolescents with chronic pain (n=12) and their parents (n=7), in addition to sporadic psychometric evaluation in these populations. As a result of the findings of these systematic measurement reviews, two multidimensional measures were developed for use specifically with adolescents with chronic pain (Bath Adolescent Pain Questionnaire; BAPQ) and their parents (Bath Adolescent Pain – Parental Impact Questionnaire). Evaluation of the BAPQ and BAP-PIQ in populations comprising adolescents with chronic pain and parents of adolescents with chronic pain, respectively, revealed psychometrically robust, multidimensional assessment tools. This study reports in detail on these completed measures with regard to guidelines for usage, use of normative data, critique of their strengths and weaknesses and discussion of how these measures can enhance assessment in a clinical setting. This study was grant supported by the BUPA Foundation and the Health Foundation.

Adolescent social development and chronic pain

Adolescents with chronic pain report disability, distress and reduced social functioning. A clinical sample of 110 adolescents, with a mean four year history of pain, was investigated for the psychosocial impact of pain on social development. All participants completed a range of self-report measures of pain intensity, disability, distress, social and family functioning. Also completed was the Bath Adolescent Pain Questionnaire, including its development subscale. The development subscale measures the extent to which adolescents perceive themselves to be ahead or behind their peers on 11 aspects of social development. Three related analyses were undertaken. First, over 50% of adolescents reported themselves to be less developed than their peers on four or more aspects. The item with the highest endorsement of being ahead compared with peers was “dealing with problems”. Second, factor analyses revealed three factors of adolescent social development labelled ‘independence’, ‘emotional adjustment’ and ‘identity formation’. Third, regression analyses revealed that peer support had a positive effect on all three factors, disability and anxiety had a negative effect on perceptions of independence, greater family dysfunction had a negative effect on emotional adjustment, and depressive mood had a negative effect on identity formation. Pain intensity had a negative effect on all three factors. Findings suggest that adolescents with chronic pain judge themselves to be less developed than their peers. Pain intensity has a negative effect on this perception, but peer relations may play a protective role: strong peer relationships are associated with positive social comparisons of the level of social development.

Disability in adolescents with chronic pain: Patterns and predictors across different domains of functioning

Many children and adolescents experience recurrent pain, but only a few become disabled by it. Research has established that higher pain intensity and worse depression seem to predict poorer functioning in this population. Parent and family variables have been minimally researched. This study investigated functional disability, social/adaptive functioning and school attendance in a population of highly disabled adolescents and their parents seeking help for chronic pain. Adolescents ( N = 110) were assessed using the Bath Adolescent Pain Questionnaire [BAPQ; Eccleston C, Jordan A, McCracken LM, Sleed M, Connell H, Clinch J. The Bath Adolescent Pain Questionnaire (BAPQ): Development and preliminary psychometric evaluation of an instrument to assess the impact of chronic pain on adolescents. Pain 2005;118:263–70], a multidimensional instrument designed for a pain population. Pain intensity and depression predicted functional disability. However, social/adaptive functioning was associated with different variables, including parent factors, and school attendance showed no association with pain intensity or anxiety. The results emphasise the need to measure multiple domains of functioning, and show that the connections between pain, physical disability and adaptive functioning are looser than might be predicted.

Development and preliminary psychometric evaluation of the parent report version of the Bath Adolescent Pain Questionnaire (BAPQ-P): A multidimensional parent report instrument to assess the impact of chronic pain on adolescents

Assessing the experience and impact of pain in adolescents with chronic pain is necessary to guide both individual treatment and to inform treatment development. Ideally, to obtain a comprehensive understanding of the impact of pain, assessment should be multidimensional, should be sensitive to contextual variables, and should allow for multiple informants (in particular, parents). The purpose of this study was to develop a standardized parent-report measure of chronic pain in adolescents, the Bath Adolescent Pain Questionnaire – Parent report (BAPQ-P). Participants included 222 adolescents with chronic pain and their parents recruited from two specialty clinics in the UK. The adolescents completed a battery of self-report inventories related to their pain and daily functioning whilst parents completed the BAPQ-P and additional measures of adolescent functioning. Scales of the BAPQ-P emerged to be internally consistent and temporally stable over a 17-day period. Validity was examined in relation to existing validated child report measures of anxiety, depression, catastrophizing, disability, family, and social functioning and parent report measures of disability and family functioning. Psychometric evaluation suggests that the BAPQ-P is a reliable and valid parental report tool for assessing the multidimensional impact of adolescent chronic pain. It can be used in conjunction with the previously established adolescent self-report measure, the BAPQ, alone where adolescent self report is not possible, in studies where parent report is the focus, or in studies where concordance between parent and adolescent reports is of interest.

The Bath Adolescent Pain Questionnaire (BAPQ): Development and preliminary psychometric evaluation of an instrument to assess the impact of chronic pain on adolescents

Chronic pain causes significant problems in the lives of many adolescents, considerably affecting their physical, psychological and social functioning. The assessment of the multidimensional impact of chronic pain is an essential clinical task. This study reports on the development and psychometric evaluation of the Bath Adolescent Pain Questionnaire (BAPQ); an assessment tool designed specifically for use with adolescents who experience chronic pain. A sample of 222 adolescents (11–18 years) experiencing chronic pain completed the 109-item draft inventory. Participants were recruited from two different UK clinics. All participants responded to items using a 5-point frequency scale. Psychometric evaluation of the data resulted in a reduced inventory length of 61 items. Internal consistency of all seven questionnaire subscales was established using Cronbach's alpha. Comparative validity was undertaken by comparison of all individual subscales with existing validated measures (SCAS, CDI-S, FDI, Brief FAM. PCS and CASAFS). The temporal reliability of each inventory subscale was established using a sub-sample of 30 adolescent participants over a 17-day period. Psychometric evaluation of the data suggests the inventory yields both a reliable and valid assessment of the impact of chronic pain on the lives of adolescents. The BAPQ may offer a comprehensive way to assess the widespread deleterious impact of adolescent chronic pain in both a research and clinical setting. Further investigation is needed on the predictive validity of the subscales. Additional data from samples of patients with diagnoses that are not musculoskeletal in origin would be of great assistance.