Pain Catastrophizing Scale

Original Editor - Evan Thomas

Top Contributors - Evan Thomas and Scott Buxton

Summary

Pain catastrophizing is characterized by the tendency to magnify the threat value of a pain stimulus and to feel helpless in the presence of pain, as well as by a relative inability to prevent or inhibit pain-related thoughts in anticipation of, during, or following a painful event.[1]

Pain catastrophizing affects how individuals experience pain. Sullivan et al 1995 state that people who catastrophize tend to do three things, all of which are measured by this questionnaire.

  1. They ruminate about their pain (e.g. "I can´t stop thinking about how much it hurts")
  2. They magnify their pain (e.g. "I´m afraid that something serious might happen")
  3. They feel helpless to manage their pain (e.g. "There is nothing I can do to reduce the intensity of my pain")

As such, the PCS was developed to help quantify an individual's pain experience, asking about how they feel and what they think about when they are in pain. Compared to other ways of measuring pain-related thoughts, this questionnaire is unique in that the individual does not need to be in pain while completing it.

It is one of the most widely used instruments for measuring catastrophic thinking related to pain, and is used extensively in clinical practice and in research.[2] The Adult Version is available in English and 20 other languages.


Intended Population

For adolescents and adults dealing with pain as the result of various pathology/disease.[3]


Method of Use

PCS Questionnaire

People are asked to indicate the degree to which they have the above thoughts and feelings when they are experiencing pain using the 0 (not at all) to 4 (all the time) scale. A total score is yielded (ranging from 0-52), along with three subscale scores assessing rumination, magnification and helplessness.


Evidence

Reliability

The PCS has been shown to have adequate to excellent internal consistency (coefficient alphas stated below):[3][4]

  • Total PCS = .87-.93
  • Rumination = .85-.91
  • Magnification = .66-.75
  • Helplessness = .78-.87


Validity

The PCS total and subscales correlated moderately and significantly with the INTRP, the Inventory of Negative Thoughts in Response to Pain, (p < .01) providing further evidence of concurrent validity for the PCS. Controlling for general psychological disturbance (MASQGeneral Disturbance) did not substantially change the magnitudes of the correlations between the PCS subscales (.43-.48) or the total PCS (partial r = .56, p < .001) and the INTRP.[4]


Responsiveness

A total PCS score of 30 represents clinically relevant level of catastrophizing. A total PCS score of 30 corresponds to the 75th percentile of the distribution of PCS scores in clinic samples of chronic pain patients.[3]


Gender Differences

Osman et al found a significant difference between men and women. These authors found that women had higher scores on the Rumination [F(286) = 3.91, p < .05] and Helplessness, [F(286) = 5.99, p < .01] subscales than did men. Also, women had higher scores on the total PCS score [F(286) = 5.55, p < .01] than did men. There was no significant difference between men and women on the Magnification subscale (p > .05).[4]


Other Versions

Cano et al (2005) went on to develop the Spouse/Significant Other Version of the PCS, known as the PCS-S. These authors figured that since pain catastrophizing appears to have a social function, then pain catastrophizing of their significant others may also have an influence on those individuals with chronic pain (ICP's).[5]

It was found that spouse catastrophizing was indeed related to ICP pain severity and interference as well as both spouses’ depressive symptoms. ICP's were also at a greater risk for psychological distress when both spouses had higher levels of catastrophizing. As such, these authors suggested that the PCS-S has the potential to be a useful and valid measure of pain catastrophizing in the spouse/significant others of ICP's.[5]


Resources


Recent Related Research (from Pubmed)


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References

  1. Quartana PJ, Campbell CM, Edwards RR. Pain Catastrophizing: A Critical Review. Expert Rev Neurother, 2009: 9(5); 745-58.
  2. The Development of the Pain Catastrophizing Scale: http://sullivan-painresearch.mcgill.ca/pcs.php
  3. 3.0 3.1 3.2 Sullivan MJL, Bishop SR, Pivik J. The Pain Catastrophizing Scale: Development and Validation. Psychol Assess, 1995; 7(4): 524-32.
  4. 4.0 4.1 4.2 Osman A, Barrios FX, Kopper BA, Hauptmann W, Jones J, O'Neill E. Factor structure, Reliability, and Validity of the Pain Catastrophizing Scale. J Behav Med, 1997; 20(6): 589-605.
  5. 5.0 5.1 Cano A, Leonard MT, Franz A. The Significant Other Version of the Pain Catastrophizing Scale (PCS-S): Preliminary Validation. Pain, 2005; 119(1-3): 26-37.