Background & Aims
Accurate pain assessments are vital for classification of chronic pain conditions, to provide information regarding severity of the condition, and guiding treatment decisions. Pain Sensitivity Questionnaire (PSQ) and Central Sensitization Inventory (CSI) are instruments, developed to assess elevated pain sensitivity and to indicate central sensitization1, 2. Only few prior studies have investigated the association between these two instruments, their reliability and validation2-4. Estimation of measurement error and detectable changes of the investigated instruments could help interpretation of changes between groups and changes over time.
The aim of the study was to investigate psychometric properties of the two pain sensitivity instruments, PSQ and CSI, their relation and possible dependence on widespread pain. A secondary aim was to investigate the association with self-reported stress symptoms using Stress and Crises Inventory (SCI-93)5 for validation purpose.
Methods
This is a cross-sectional study with a study sample consisted of 293 responders (21 men and 272 women) recruited from pain-related interest organisations and a pain specialist unit. In the sample the prevalence of chronic widespread pain was 62% and chronic pain (not widespread) 34%. The mean age was 52 years, with lowest age of 19 years and highest age of 82 years. Of the responders 59% had a university education and 36% had a upper secondary education. The range for the three main instruments were from 0 to 10 for PSQ, from 0 to 100 for CSI, and 0 to 140 for SCI-93. To estimate reliability Cronbach´s alpha was used, and in the estimation of the standard error of measurement (SEM) and Minimal detectable change (MDC)7. The SEM was assumed to be similar at different time points, which was needed in the calculation of MDC as the study was cross-sectional6.
Results
Reliability was high for all instruments (PSQ=0.93, CSI=0.89, SCI-93=0.94). The SEM for the three instruments was: PSQ=0.48, CSI=5.1, SCI-93=6.4, and the MDC: PSQ=1.3, CSI=14.3, SCI-93=17.8.
From a validity perspective CSI and SC-93 were closely correlated, while PSQ were only slightly positively associated with CSI and SCI-93. The correlation between CSI and SCI-93 was similar in the three pain-related categories (Spearmen r = 0.84, 0.82 and 0.95). For PSQ the correlation with CSI and CSI-93 respectively differed in the three pain-related categories, with the strongest correlation in the group with chronic widespread pain (Spearman r = 0.45-0.46). In the other two pain-related groups the Spearman r varied from 0.10 to 0.31.
Conclusions
For all three instruments SEM was approximately 5% of the range of the scales. Also, MDC was similar in proportion between the three instruments. PSQ measures pain over-sensitivity in an everyday setting, while CSI captures a pattern of symptoms forming the central sensitisation syndrome. CSI was closely related to clinical manifestation of stress symptoms in the SCI-93, while PSQ was slightly correlated with CSI and SCI-93, but only among persons with chronic widespread pain.
References
- Mayer TG, Neblett R, Cohen H, Howard KJ, Choi YH, Williams MJ, Perez Y, Gatchel, RJ. The Development and Psychometric Validation of the Central Sensitization Inventory. Pain Practice 2012;12:276–285.
- Ruscheweyh R, Marziniak M, Stumpenhorst F, Reinholz J, Knecht S. Pain sensitivity can be assessed by self-rating: Development and validation of the Pain Sensitivity Questionnaire. Pain 2009;146:65–74.
- Sellers AB, Ruscheweyh R, Kelley BJ, Ness TJ, Vetter TR. Validation of the English Language Pain Sensitivity Questionnaire. Reg Anesth Pain Med 2013;38:508–514.
- Valeberg BT, Pedersen LM, Girotto V, Christensen VL, Stubhaug A. Validation of the Norwegian Pain Sensitivity Questionnaire. J Pain Res 2017;Volume 10:1137–1142.
- Ericsson A, Nyström C, Mannerkorpi K. Psychometric properties of the Stress and Crisis Inventory (SCI-93) in females with fibromyalgia and chronic widespread pain. Nord J Psychiatry 2015;69:28–34.
- Wolfe F, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990
- Grönkvist R, Vixner L, Äng B, Grimby-Ekman A. Measurement error, minimal detectable change, and minimal clinically important difference of the Short Form-36 Health Survey, Hospital Anxiety and Depression Scale, and Pain Numeric Rating Scale in patients with chronic pain. J Pain 2024
Presenting Author
Anna Grimby
Poster Authors
Topics
- Assessment and Diagnosis