title: Pain-related fear: a critical review of the related measures.
abstract: OBJECTIVE
  In regards to pain-related fear, this study aimed to: (1) identify existing measures and review their measurement properties, and (2) identify the optimum measure for specific constructs of fear-avoidance, pain-related fear, fear of movement, and kinesiophobia.
  
  
  METHODS
  Systematic literature search for instruments designed to measure fear of pain in patients with persistent musculoskeletal pain. Psychometric properties were evaluated by adjusted Wind criteria.
  
  
  RESULTS
  Five questionnaires (Fear-Avoidance Beliefs Questionnaire (FABQ), Fear-Avoidance of Pain Scale (FAPS), Fear of Pain Questionnaire (FPQ), Pain and Anxiety Symptoms Scale (PASS), and the Tampa Scale for Kinesiophobia (TSK)) were included in the review. The main findings were that for most questionnaires, there was no underlying conceptual model to support the questionnaire's construct. Psychometric properties were evaluated by diverse methods, which complicated comparisons of different versions of the same questionnaires. Construct validity and responsiveness was generally not supported and/or untested.
  
  
  CONCLUSIONS
  The weak construct validity implies that no measure can currently identify who is fearful. The lack of evidence for responsiveness restricts the current use of the instruments to identify clinically relevant change from treatment. Finally, more theoretically driven research is needed to support the construct and thus the measurement of pain-related fear.
authors.affiliation: Division of Occupational Orthopedics, Department of Orthopedics, Sahlgrenska University Hospital, University of Gothenburg, Göteborg, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Lundberg
authors.forename: A
authors.initials: A
authors.lastname: Grimby-Ekman
authors.forename: J
authors.initials: J
authors.lastname: Verbunt
authors.forename: M J
authors.initials: MJ
authors.lastname: Simmonds