Darnall Beth D, Sturgeon John A, Cook Karon F, Taub Chloe J, Roy Anuradha, Burns John W, Sullivan Michael, Mackey Sean C
Stanford Systems Neuroscience and Pain Lab, Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California.
Stanford Systems Neuroscience and Pain Lab, Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California.
J Pain. 2017 Sep;18(9):1139-1149. doi: 10.1016/j.jpain.2017.05.003. Epub 2017 May 19.
To date, there is no validated measure for pain catastrophizing at the daily level. The Pain Catastrophizing Scale (PCS) is widely used to measure trait pain catastrophizing. We sought to develop and validate a brief, daily version of the PCS for use in daily diary studies to facilitate research on mechanisms of catastrophizing treatment, individual differences in self-regulation, and to reveal the nuanced relationships between catastrophizing, correlates, and pain outcomes. After adapting the PCS for daily use, we evaluated the resulting 14 items using 3 rounds of cognitive interviews with 30 adults with chronic pain. We refined and tested the final daily PCS in 3 independent, prospective, cross-sectional, observational validation studies conducted in a combined total of 519 adults with chronic pain who completed online measures daily for 14 consecutive days. For study 1 (N = 131), exploratory factor analysis revealed adequate fit and-unexpectedly-unidimensionality for item responses to the daily PCS. Study 2 (N = 177) correlations indicated adequate association with related constructs (anger, anxiety, pain intensity, depression). Similarly, results for study 3 (N = 211) revealed expected correlations for daily PCS and measures of daily constructs including physical activity, sleep, energy level, and positive affect. Results from complex/multilevel confirmatory factor analysis confirmed good fit to a unidimensional model. Scores on the daily PCS were statistically comparable with and more parsimonious than the full 14-item version. Next steps include evaluation of score validity in populations with medical diagnoses, greater demographic diversity, and in patients with acute pain.
This article describes the development and validation of a daily PCS. This daily measure may facilitate research that aims to characterize pain mechanisms, individual differences in self-regulation, adaptation, and nuanced relationships between catastrophizing, correlates, and pain outcomes.
迄今为止，尚无经过验证的每日疼痛灾难化测量方法。疼痛灾难化量表（PCS）被广泛用于测量特质性疼痛灾难化。我们试图开发并验证一个简短的、每日版的PCS，用于日常日记研究，以促进对灾难化治疗机制、自我调节个体差异的研究，并揭示灾难化、相关因素和疼痛结果之间的细微关系。在将PCS改编为每日使用版本后，我们对30名慢性疼痛成年人进行了三轮认知访谈，以评估由此产生的14个项目。我们在3项独立的、前瞻性的、横断面的观察性验证研究中对最终的每日PCS进行了完善和测试，共有519名慢性疼痛成年人参与，他们连续14天每天完成在线测量。在研究1（N = 131）中，探索性因素分析显示，每日PCS项目反应的拟合度良好且出乎意料地为单维度。研究2（N = 177）的相关性表明与相关构念（愤怒、焦虑、疼痛强度、抑郁）有足够的关联。同样，研究3（N = 211）的结果显示，每日PCS与包括身体活动、睡眠、能量水平和积极情绪在内的每日构念测量之间存在预期的相关性。复杂/多层次验证性因素分析的结果证实了对单维度模型的良好拟合。每日PCS的得分在统计学上与完整的14项版本相当，且更为简约。下一步包括评估在患有医学诊断疾病、人口统计学差异更大的人群以及急性疼痛患者中的得分有效性。
本文描述了每日PCS的开发和验证。这种每日测量方法可能有助于旨在表征疼痛机制、自我调节个体差异、适应性以及灾难化、相关因素和疼痛结果之间细微关系的研究。
