title: 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) reports, along with additional measures of psychological functioning. The measure's psychometric properties were examined, as were 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 3-dimension structure, and we recommend potentially removing items 7 and 8 for both the PCS-P and PCS-C as a result of floor/ceiling effects. The 11-item PCS-C is most parsimonious as a unitary construct, while the 11-item PCS-P comprises 2 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. 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.
authors.affiliation: Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA; P.A.I.N. Group, Boston Children's Hospital, Center for Pain and the Brain, Harvard Medical School, Cambridge, MA, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Pielech
authors.affiliation: Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Maggie
authors.initials: M
authors.lastname: Ryan
authors.affiliation: Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA.
authors.forename: Deirdre
authors.initials: D
authors.lastname: Logan
authors.affiliation: Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Kaczynski
authors.affiliation: Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: White
authors.affiliation: Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA; P.A.I.N. Group, Boston Children's Hospital, Center for Pain and the Brain, Harvard Medical School, Cambridge, MA, USA; Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA. Electronic address: laura.simons@childrens.harvard.edu.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Simons
mesh_terms: D000293:Adolescent; D058443:Catastrophization / Q000175:diagnosis* / Q000209:etiology*; D002648:Child; D059350:Chronic Pain / Q000150:complications* / Q000523:psychology*; D006233:Persons with Disabilities; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010290:Parents / Q000523:psychology*; D011594:Psychometrics; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
keywords: Adolescent; Assessment; Catastrophizing; Child; Chronic pain; Disability; Measurement; PCS-C; PCS-P; Parent