Cook Karon F, Mackey Sean, Jung Corinne, Darnall Beth D
Feral Scholars, Broaddus, TX, USA.
Department Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, USA.
Pain Rep. 2021 Mar 17;6(1):e909. doi: 10.1097/PR9.0000000000000909. eCollection 2021.
Increasingly, studies have documented the negative impact of pain catastrophizing on health outcomes. The Pain Catastrophizing Scale (PCS) has been the measure of choice for many of these studies. The PCS provides 3 subscales for measuring pain catastrophizing: rumination, magnification, and helplessness. Factor analytic investigations of these factors have been limited by the sample size and relevance, and results have been inconsistent. No study has directly estimated the added value of subscale scoring of the PCS compared with scoring it as a single measure.
The purpose of this study was to evaluate the dimensionality of PCS responses in a sample of patients with chronic pain (N = 8370).
Data were randomly halved, and results were cross-validated. Both traditional factor analysis and traditional factor analyses were conducted.
Findings based on common factor analyses and on bifactor analyses supported the essential unidimensionality of PCS responses. In the bifactor analyses, the general factor accounted for 96% of the explained common variance in the modeling sample. After extracting the general factor, helplessness, magnification, and rumination subscales accounted for 7.0%, 0.0%, and 15%, respectively.
The results do not necessarily disconfirm helplessness, magnification, and rumination as clinically meaningful theoretical distinctions. However, the PCS (at least as presently constructed) fails to discriminate these distinctions. Joint efforts in theory and measurement science could illuminate the role that posited "kinds" of pain catastrophizing play in individuals' pain experiences.
越来越多的研究记录了疼痛灾难化对健康结果的负面影响。疼痛灾难化量表（PCS）一直是许多此类研究的首选测量工具。PCS提供了3个用于测量疼痛灾难化的分量表：沉思、放大和无助。对这些因素的因素分析研究受到样本量和相关性的限制，结果也不一致。没有研究直接估计与将PCS作为单一测量工具评分相比，其分量表评分的附加价值。
本研究的目的是评估慢性疼痛患者样本（N = 8370）中PCS反应的维度。
数据随机分成两半，并进行交叉验证。同时进行了传统因素分析和传统因素分析。
基于共同因素分析和双因素分析的结果支持了PCS反应本质上的单维度性。在双因素分析中，一般因素在建模样本中解释的共同方差中占96%。提取一般因素后，无助、放大和沉思分量表分别占7.0%、0.0%和15%。
这些结果不一定否定无助、放大和沉思作为具有临床意义的理论区分。然而，PCS（至少目前的构建方式）未能区分这些差异。理论和测量科学方面的共同努力可以阐明假定的不同“类型”的疼痛灾难化在个体疼痛体验中所起的作用。
