The development of the negative pain thoughts questionnaire.
BACKGROUND
Cognitive processes play a pivotal role in the perception of pain intensity, pain-related disability, and response to medical treatments including surgeries. While various measures of dysfunctional pain coping exist in the literature, there is no instrument available to examine such negative cognitions in relation to perceptions of medical treatment in pain patients presenting to a surgical orthopedics practice.


OBJECTIVE
The purpose of this article is to report on the development and preliminary testing of the Negative Pain Thoughts Questionnaire (NPTQ).


METHODS
The NPTQ is an 11-item questionnaire assessing cognitions about pain and its treatment in patients presenting to orthopedics surgical practices. It was administered to 2 samples of patients with hand and arm pain seeking medical treatment in a hospital surgical practice. Patients in the second sample also completed a measure of depression and one of disability of hand, arm, and shoulder.


RESULTS
The NPTQ was found to be internally consistent, and unidimensional. The NPTQ total score was found to have a moderate to high positive correlation with perceived hand, arm, and shoulder disability, and a moderate positive correlation with depression. In multivariate analyses, high scores on the NPTQ significantly predicted high perceived hand, arm, and shoulder disability, even after controlling for depression.


CONCLUSIONS
This short and easily administered measure of negative pain thoughts could potentially help surgeons identify at risk patients, and facilitate referrals to cognitive behavioral therapy. This, in turn, may prevent unnecessary surgeries, may decrease healthcare costs, and prevent transition toward costly chronic pain syndrome.
Vranceanu
Ana-Maria
AM
Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
Safren
Steve
S
Cowan
James
J
Ring
David
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D001132:Arm / Q000503:physiopathology; D015928:Cognitive Behavioral Therapy / Q000592:standards; D020918:Complex Regional Pain Syndromes / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D003866:Depressive Disorder / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D004185:Disability Evaluation; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards*; D010146:Pain / Q000150:complications / Q000523:psychology*; D010147:Pain Measurement / Q000379:methods*; D011237:Predictive Value of Tests; D013315:Stress, Psychological / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D011795:Surveys and Questionnaires / Q000592:standards*; D055815:Young Adult