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Background: Assessing features of centralized pain may prove to be clinically meaningful in pediatric populations. However, we are currently limited by the lack of validated pediatric measures. Aim: We examined the psychometric properties of the Widespread Pain Index (WPI) and Symptom Severity (SS) scale to assess features of centralized pain in youth with painful conditions from three clinical samples: (1) musculoskeletal surgery, (2) headache, and (3) chronic pain. Methods: Participants were 240 youth aged 10 to 18 years (M age = 14.8, SD = 1.9) who completed the WPI and SS scale. Subsets of participants also completed additional measures of pain region, pain intensity, quality of life, pain interference, and physical function. Results: Increased features of centralized pain by age were seen for the WPI (r = 0.27, P < 0.01) and SS scale (r = 0.29, P < 0.01). Expected differences in sex were seen for the WPI (sex: t 132 = −3.62, P < 0.01) but not the SS scale (sex: t 223 = −1.73, P = 0.09). Reliability for the SS scale was adequate (α = 0.70). Construct validity was demonstrated through relationships between the WPI and pain regions (r = 0.57, P < 0.01) and between the SS scale and quality of life (r = −0.59, P < 0.01) and pain interference (r = 0.56, P < 0.01). Criterion validity was demonstrated by differences on the WPI between the surgery sample and the headache and chronic pain samples (F 2,237 = 17.55, P < 0.001). Comprehension of the SS scale items was problematic for some youth. Conclusions: The WPI showed adequate psychometric properties in youth; however, the SS scale may need to be modified. Our findings support the need to develop psychometrically sound instruments for comprehensive assessment of pain in pediatric samples.

Background Spinal fusion surgery is a common and painful musculoskeletal surgery performed in the adolescent population. Despite the known risk for developing chronic postsurgical pain, few perioperative psychosocial interventions have been evaluated in this population, and none have been delivered remotely (via the Internet) to improve accessibility. Aims The aim of this single-arm pilot study was to evaluate the feasibility and acceptability of the first Internet-based psychological intervention delivered during the perioperative period to adolescents undergoing major spinal fusion surgery and their parents. Methods Thirteen adolescents (M age = 14.3; 69.2% female) scheduled for spine fusion surgery and their parents were provided access to the online psychosocial intervention program. The program included six lessons delivering cognitive-behavioral therapy skills targeting anxiety, sleep, and acute pain management during the month prior to and the month following surgery. Feasibility indicators included recruitment rate, intervention engagement, and measure completion. Acceptability was assessed via quantitative ratings and qualitative interviews. Results Our recruitment rate was 81.2% of families approached for screening. Among participating adolescent–parent dyads, high levels of engagement were demonstrated (100% completed all six lessons). All participants completed outcome measures. High treatment acceptability was demonstrated via survey ratings and qualitative feedback, with families highlighting numerous strengths of the program as well as areas for improvement. Conclusions These findings suggest that this online psychosocial intervention delivered during the perioperative period is feasible and acceptable to adolescents and their parents. Given favorable feasibility outcomes, an important next step is to evaluate the intervention in a full-scale randomized controlled trial.