Kröner-Herwig Birgit, Maas Jennifer
Georg-Elias-Müller-Institute, University of Göttingen, Dept. of Clinical Psychology and Psychotherapy, Göttingen, Germany.
Psychosoc Med. 2013 Aug 2;10:Doc07. doi: 10.3205/psm000097. Print 2013.
The Pain Catastrophizing Scale, adapted for children (PCS-C) by Crombez et al. (2003), was translated into German (SKS-D) and evaluated regarding its factorial structure, its reliability and validity. The association of catastrophizing with various pain characteristics and disability measures was examined as well as its association to neighboring constructs.
The paper-and-pencil version of the SKS-D was used in two different samples of children and adolescents. Analyses were conducted on a subgroup of participants from an epidemiological sample [n=898; age: M=12.9 (SD=1.4)] who had experienced monthly headaches in the 6-months period before and a clinical sample [n=60; age: M=12.6 (SD=0.8)] seeking treatment for recurrent headaches.
Exploratory factor analysis (PCA) suggested a one-factor model in contrast to the 3-factor model suggested by Crombez et al. (2003). The unidimensional scale showed distinct homogeneity and satisfying reliability. The clinical sample showed significantly higher scores than the epidemiological group. Also girls scored higher than boys. The catastrophizing explained a considerable amount of variance in pain and disability parameters in both samples thus underlining its validity. The psychological variables internalising, anxiety sensitivity and somatosensory amplification showed significant small to moderate associations with pain catastrophizing and also with pain and disability. After controlling for the above mentioned psychological variables, catastrophizing still yielded an independent contribution to the explanation of variance in pain and disability parameters.
The PCS-C in its German form is a valid and reliable instrument for assessing catastrophizing in children with recurrent pain, in particular headache, in the age of 10-16 years. Pain catastrophizing is suggested to be assessed especially in pediatric pain patients as it is a significant moderator of pain and disability. In children with a distinct tendency to catastrophize cognitive restructuring should become a target of pediatric pain therapy, as a reduction of catastrophizing cognitions may indirectly help to ameliorate pain and disability.
由克伦贝兹等人（2003年）改编的儿童疼痛灾难化量表（PCS-C）被翻译成德语（SKS-D），并对其因子结构、信度和效度进行评估。研究了灾难化与各种疼痛特征和残疾测量指标之间的关联，以及它与相邻结构的关联。
SKS-D的纸笔版本在两个不同的儿童和青少年样本中使用。对来自一个流行病学样本（n = 898；年龄：M = 12.9（标准差 = 1.4））的参与者亚组进行分析，这些参与者在之前的6个月内每月都有头痛经历，以及一个因复发性头痛寻求治疗的临床样本（n = 60；年龄：M = 12.6（标准差 = 0.8））。
探索性因子分析（主成分分析）表明是单因素模型，这与克伦贝兹等人（2003年）提出的三因素模型不同。这个单维量表显示出明显的同质性和令人满意的信度。临床样本的得分显著高于流行病学组。女孩的得分也高于男孩。灾难化解释了两个样本中疼痛和残疾参数的相当一部分变异，从而强调了其效度。内化、焦虑敏感性和体感放大等心理变量与疼痛灾难化以及疼痛和残疾都显示出显著的小到中等程度的关联。在控制了上述心理变量后，灾难化仍然对疼痛和残疾参数变异的解释有独立贡献。
德语版的PCS-C是评估10 - 16岁复发性疼痛儿童，特别是头痛儿童灾难化的有效且可靠的工具。建议在儿科疼痛患者中特别评估疼痛灾难化，因为它是疼痛和残疾的重要调节因素。在有明显灾难化倾向的儿童中，认知重构应成为儿科疼痛治疗的目标，因为减少灾难化认知可能间接有助于减轻疼痛和残疾。
