title: Validation of the German fear of pain questionnaire in a sample of children with mixed chronic pain conditions.
abstract: To date, no German instrument exists to measure pain-related fear in paediatric pain populations. The objective of the current study was to determine the construct validity of the translated German fear of pain questionnaire for children (GFOPQ-C) in a sample of children with mixed chronic pain disorders by testing the underlying factor structure, and its psychometric properties.
  
  
  
  N = 241 children with mixed chronic pain disorders (aged 8-19 years) presenting to a specialized pain clinic completed the GFOPQ-C and several other pain, fear and disability measures.
  
  
  
  The two-factor structure of the FOPQ-C (fear, avoidance) was replicated. Internal consistency for the shortened German version was good for both subscales (Fear subscale: α = 0.89; avoidance subscale: α = 0.76). As expected, the fear subscale correlated highly with anxiety sensitivity (r = 0.63), pain catastrophizing (r = 0.62) and general anxiety (r = 0.54), while the avoidance subscale was more closely related to disability (r = 0.24) and school functioning (r = 0.28). Pain-related fear differed in children with chronic pain depending on their pain location with higher fear ratings in children with abdominal pain and musculoskeletal pain.
  
  
  
  The GFOPQ-C is a valid instrument that assesses two distinct dimensions of pain-related fear in children: fear and avoidance. Future research is needed to evaluate the impact of increased pain-related fear on outcomes over time as well as to examine pain-related fear among healthy children. This will enhance our knowledge of who might be particularly vulnerable to potentially dysfunctional trajectories, such as ongoing pain or anxiety symptoms.
  
  
  
  The current study validates the first tool to assess pain-related fear in German-speaking children with chronic pain. Findings support two distinct domains: fear and activity avoidance.
authors.affiliation: German Paediatric Pain Centre, Children's and Adolescent's Hospital, Datteln, Germany.|Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health - School of Medicine, Witten/Herdecke University, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Flack
authors.affiliation: Department of Psychology, Institute of Clinical Psychology and Psychotherapy, University of Cologne, Germany.
authors.forename: A L
authors.initials: AL
authors.lastname: Gerlach
authors.affiliation: Department of Anaesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, USA.
authors.forename: L E
authors.initials: LE
authors.lastname: Simons
authors.affiliation: German Paediatric Pain Centre, Children's and Adolescent's Hospital, Datteln, Germany.|Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health - School of Medicine, Witten/Herdecke University, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Zernikow
authors.affiliation: Department of Clinical Child and Adolescent Psychology and Psychotherapy, University of Trier, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Hechler
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000523:psychology*; D002648:Child; D002908:Chronic Disease / Q000523:psychology*; D059350:Chronic Pain / Q000503:physiopathology* / Q000523:psychology; D006233:Persons with Disabilities; D005239:Fear / Q000523:psychology*; D006801:Humans; D059352:Musculoskeletal Pain / Q000503:physiopathology*; D018710:Pain Clinics; D010147:Pain Measurement / Q000379:methods; D010698:Phobic Disorders / Q000523:psychology*; D011594:Psychometrics; D015203:Reproducibility of Results; D013001:Somatoform Disorders / Q000503:physiopathology*; D011795:Surveys and Questionnaires