Pain catastrophizing in children with chronic pain and their parents: Proposed clinical reference points and reexamination of the Pain Catastrophizing Scale measure

Abstract

The current study aimed to validate the child and parent pain catastrophizing scale in a large chronic pain sample and to identify child pain catastrophizing clinical reference points. Patients and parents (n= 697) evaluated at a pediatric pain program completed the Pain Catastrophizing Scale, child (PCS-C) and parent (PCS-P) report, along with additional measures of psychological functioning. The measure’s psychometric properties were examined, as well as relations across demographic, pain, and psychological characteristics and pain catastrophizing. Clinical reference points were identified for the PCS-C from differences in pain catastrophizing across levels of disability, depressive symptoms, and anxiety. Overall, we did not find support for the hypothesized three-dimension structure and recommend potentially removing items 7 and 8 for both the PCS-P and PCS-C due to floor/ceiling effects. The 11-item PCS-C is most parsimonious as a unitary construct, while the 11 item PCS-P is comprised of two factors. Although parent catastrophizing was significantly associated with child outcomes after controlling for pain level, it was no longer significant when accounting for child catastrophizing. When comparing PCS-C scores based on child outcomes, significant differences emerged for low, moderate, and high catastrophizing levels. It appears that the influence of parent catastrophizing on outcomes can be explained through its impact on child catastrophizing levels. Lastly, PCS-C reference points derived from this large sample can aid clinicians in assessment and treatment planning, in turn increasing the utility of the PCS-C for both clinical and research purposes.

Perceived Injustice Is Associated With Pain and Functional Outcomes in Children and Adolescents With Chronic Pain: A Preliminary Examination

“…A potentially important factor in the pediatric context is parental perceptions of injustice, as research shows that parental coping is related, both behaviorally and genetically, to children/adolescents pain experience and appraisal [59,64]. For example, parental pain catastrophizing has been positively associated with adolescent catastrophizing, pain-related disability, and somatic complaints [14,37,62,65].…”

Living in fear of your child's pain

“…The PCS-C includes 13 items, which are rated on a 5-point scale ranging from 0 = “not at all true” to 4 = “very true.” Items are summed to derive a total score ranging from 0-52; higher scores reflect higher levels of catastrophic thinking. Clinical reference points for the PCS-C are low (0-14), moderate (15-25), and high (26 and greater) catastrophizing [29]. Internal reliability for the current sample was .93 for the PCS-C…”

Pain Response after Maximal Aerobic Exercise in Adolescents across Weight Status

“…The questionnaire has 13 statements that are scored in a Likert Scale (0-5) with three subcategories: rumination, magnification, and helplessness. Higher PCS scores are indicative of higher pain catastrophizing with clinical reference points for the PCS-C as low (0-14), moderate (15-25), and high (> 26) (28). …”