PRIDE Research Foundation, Dallas, Texas 75235, USA.
Pain Pract. 2011 Sep-Oct;11(5):430-8. doi: 10.1111/j.1533-2500.2011.00448.x. Epub 2011 Mar 25.
The Pain Anxiety Symptoms Scale (PASS) was developed to measure fear and anxiety responses to pain. Many studies have found associations between PASS scores and self-report measures of pain, anxiety, and disability as well as among inhibited movement patterns and activity avoidance behaviors (eg, kinesophobia). This study aimed to identify clinically meaningful cut-off points to identify high or low levels of pain anxiety and to determine if the PASS provides additional useful information in a functional restoration (FR) treatment program for chronic disabling occupational musculoskeletal disorder (CDOMD) patients.
A consecutive cohort of 551 patients with CDOMD, who entered and completed a FR program, was administered a battery of psychosocial assessments, including the PASS, at admission and discharge. Socioeconomic outcomes were collected 1 year after discharge. After identifying clinical ranges for mild, moderate, and severe pain anxiety, the three groups were compared on self-report measures of psychosocial distress, clinical diagnoses of psychosocial disorders, and 1-year socioeconomic outcomes.
Correlations between the PASS and all measures of pain, anxiety, and disability were statistically significant. However, only the Pain Disability Questionnaire showed a large correlation coefficient (r > 0.5). Patients with the highest PASS scores were more likely to be diagnosed with a number of Axis I (depression, opioid dependence) or Axis II (Borderline Personality) psychiatric disorders. They were more likely to display treatment-seeking behavior at 1 year after discharge. However, the PASS failed to differentiate between any other 1-year outcomes.
The PASS is elevated when other measures of psychosocial distress are also elevated. However, the PASS fails to discriminate between different indices of depression and anxiety and it is not highly related to 1-year outcomes in a CDOMD cohort. If time and resources are limited, a different measure of psychosocial distress that does relate to socioeconomic outcomes might be a better option in a CDOMD evaluation process.
疼痛焦虑症状量表（PASS）旨在衡量对疼痛的恐惧和焦虑反应。许多研究发现，PASS 评分与疼痛、焦虑和残疾的自我报告测量之间存在关联，以及抑制运动模式和活动回避行为（例如，运动恐惧）之间存在关联。本研究旨在确定临床上有意义的截断值，以确定疼痛焦虑的高低水平，并确定 PASS 是否在慢性致残性职业肌肉骨骼障碍（CDOMD）患者的功能恢复（FR）治疗计划中提供额外的有用信息。
连续入组的 551 名 CDOMD 患者，他们参加并完成了 FR 计划，在入院和出院时接受了一系列社会心理评估，包括 PASS。出院后 1 年收集社会经济结果。在确定轻度、中度和重度疼痛焦虑的临床范围后，将这三组在自我报告的心理困扰、心理障碍的临床诊断和 1 年社会经济结果方面进行比较。
PASS 与疼痛、焦虑和残疾的所有测量指标之间的相关性均具有统计学意义。然而，只有疼痛残疾问卷（Pain Disability Questionnaire）显示出较大的相关系数（r > 0.5）。PASS 得分最高的患者更有可能被诊断为多种轴 I（抑郁、阿片类药物依赖）或轴 II（边缘型人格）精神障碍。他们更有可能在出院后 1 年寻求治疗。然而，PASS 未能区分任何其他 1 年的结果。
当其他社会心理困扰测量指标也升高时，PASS 会升高。然而，PASS 无法区分不同的抑郁和焦虑指标，并且与 CDOMD 队列的 1 年结果相关性不强。如果时间和资源有限，在 CDOMD 评估过程中，可能需要选择与社会经济结果相关的其他社会心理困扰指标。
