The Fear of Pain Questionnaire (FOPQ): Assessment of Pain-Related Fear Among Children and Adolescents With Chronic Pain
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Unlabelled An important construct in understanding pain-related disability is pain-related fear. Heightened pain-related fear may result in behavioral avoidance leading to disuse, disability, and depression; whereas confrontation of avoided activities may result in a reduction of fear over time and reengagement with activities of daily living. Although there are several measures to assess pain-related fear among adults with chronic pain, none exist for children and adolescents. The aim of the current study was to develop a new tool to assess avoidance and fear of pain with pediatric chronic pain patients: the Fear of Pain Questionnaire, child report (FOPQ-C), and Fear of Pain Questionnaire, parent proxy report (FOPQ-P). After initial pilot testing, the FOPQ-C and FOPQ-P were administered to 299 youth with chronic pain and their parents at an initial multidisciplinary pain treatment evaluation. The FOPQ demonstrated very strong internal consistency of .92 for the child and parent versions. One-month stability estimates were acceptable and suggested responsivity to change. For construct validity, the FOPQ correlated with generalized anxiety, pain catastrophizing, and somatization. Evidence of criterion-related validity was found with significant associations for the FOPQ with pain, healthcare utilization, and functional disability. These results support the FOPQ as a psychometrically sound measure. Perspective Pain-related fear plays an important role in relation to emotional d…
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The FOPQ-C cut-off ≥35 indicates moderate to high pain-related fear.
“moderate to high pain-related fear (Fear of Pain Questionnaire- FOPQ-C] ≥ 35)[57]”
From A randomized controlled trial of graded exposure treatment (GET living) for adolescents with chronic pain (2024) · cites this paper as [57]
Patients were randomized to GL or MPM and stratified by pain-related fear and functional disability to minimize imbalance.
“Following the pre-treatment baseline phase, patients were randomized to one of two treatment conditions (GL or MPM) and were stratified by pain-related fear (low/moderate [FOPQ-C <50], and high [FOPQ-C=50–96]; derived from validation sample[57]) and functional disability (low/moderate [FDI<30] and severe [FDI=30–60][28]) to minimize the probability of imbalance between the two treatment arms.”
From A randomized controlled trial of graded exposure treatment (GET living) for adolescents with chronic pain (2024) · cites this paper as [57]
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Rosenbloom, B. N., Pagé, M. G., Isaac, L., Campbell, F. A., Stinson, J., Cribbie, R. A., & Katz, J. D. (2020) · European Journal of Pain · doi:10.1002/ejp.1643 · Cited by 32 · see citing works
Living Life With My Child’s Pain: The Parent Pain Acceptance Questionnaire (PPAQ)
Smith, A. M., Sieberg, C. B., Odell, S., Randall, E., & Simons, L. E. (2015) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000000140 · Cited by 31 · see citing works
Self-citationSieberg, C. B., Smith, A., White, M. T., Manganella, J. L., Sethna, N. F., & Logan, D. E. (2016) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsw046 · Cited by 31 · see citing works
Self-citationRandall, E. T., Smith, K. R., Kronman, C. A., Conroy, C., Smith, A., & Simons, L. E. (2017) · Journal of Pain · doi:10.1016/j.jpain.2017.11.012 · Cited by 31 · see citing works
Self-citationRiggenbach, A., Goubert, L., Petegem, S. V., & Amouroux, R. (2019) · Pain Research and Management · doi:10.1155/2019/8629581 · Cited by 36 · see citing works
State of The Art in Biobehavioral Approaches to the Management of Chronic Pain in Childhood
Simons, L. E., & Basch, M. C. (2015) · Pain Management · doi:10.2217/pmt.15.59 · Cited by 31 · see citing works
Self-citationPredictors and trajectories of chronic postoperative pain following hip preservation surgery
Sieberg, C. B., Klajn, J., Wong, C., Bowen, G. S., Simons, L. E., & Millis, M. B. (2017) · Journal of Hip Preservation Surgery · doi:10.1093/jhps/hnx003 · Cited by 30 · see citing works
Self-citationRapid identification and clinical indices of fear-avoidance in youth with chronic pain
Heathcote, L. C., Bhandari, R. P., Timmers, I., Harrison, L. E., & Simons, L. E. (2019) · Pain · doi:10.1097/j.pain.0000000000001742 · Cited by 29 · see citing works
Self-citationThe Concept of Pain Inventory (COPI)
Pate, J. W., Simons, L. E., Hancock, M. J., Hush, J. M., Noblet, T., Pounder, M., & Pacey, V. (2020) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000884 · Cited by 29 · see citing works
Self-citationFlack, F., Stahlschmidt, L., Dobe, M., Hirschfeld, G., Strasser, A., Michalak, J., Wager, J., & Zernikow, B. (2018) · Pain · doi:10.1097/j.pain.0000000000001321 · Cited by 28 · see citing works
Harvey, A. R., Smith, N. L., Smith, M. Y., Ostojic, K., & Berryman, C. F. (2024) · BMC Medicine · doi:10.1186/s12916-024-03458-0 · Cited by 30 · see citing works
Nelson, S., Bento, S. P., & Enlow, M. B. (2021) · Children · doi:10.3390/children8080709 · Cited by 26 · see citing works
Simons, L. E., Harrison, L. E., O'Brien, S. F., Heirich, M. S., Loecher, N., Boothroyd, D. B., Vlaeyen, J. W. S., Wicksell, R. K., Schofield, D., Hood, K. K., et al. (2019) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2019.100448 · Cited by 24 · see citing works
“For the last decade our group has focused on pain-related fear and avoidance in children, with efforts centered on effective assessment [4,6] and intervention [3,18].”
BackgroundMethodSelf-citationSzabó, E., Timmers, I., Borsook, D., Simons, L. E., & Sieberg, C. B. (2022) · European Journal of Paediatric Neurology · doi:10.1016/j.ejpn.2022.10.004 · Cited by 24 · see citing works
Self-citationPediatric pain screening identifies youth at risk of chronic pain in sickle cell disease
Sil, S., Cohen, L. L., & Dampier, C. (2018) · Pediatric Blood & Cancer · doi:10.1002/pbc.27538 · Cited by 26 · see citing works
Anxiety sensitivity and fear of pain in paediatric headache patients
Cappucci, S. P., & Simons, L. E. (2014) · European Journal of Pain · doi:10.1002/ejp.542 · Cited by 24 · see citing works
Self-citationDekker, C., Goossens, M. E. J. B., Bastiaenen, C. H. G., & Verbunt, J. A. M. C. F. (2016) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-016-1178-5 · Cited by 23 · see citing works
Beeckman, M., Simons, L. E., Hughes, S., Loeys, T., & Goubert, L. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.02350 · Cited by 24 · see citing works
Self-citationChrisman, S. P. D., Mendoza, J. A., Zhou, C., Palermo, T. M., Gogue-Garcia, T., Janz, K. F., & Rivara, F. P. (2021) · Frontiers in Pediatrics · doi:10.3389/fped.2021.645814 · Cited by 23 · see citing works
Endogenous pain modulation in children with functional abdominal pain disorders
Pas, R., Rheel, E., Oosterwijck, S. V., Leysen, L., de Vijver, E. V., Nijs, J., Ickmans, K., & Meeus, M. (2019) · Pain · doi:10.1097/j.pain.0000000000001566 · Cited by 23 · see citing works
Stommen, N. C., Verbunt, J., GORTER, S. L., & Goossens, M. E. J. B. (2012) · Disability and Rehabilitation · doi:10.3109/09638288.2011.645112 · Cited by 23 · see citing works
Verbunt, J., Nijhuis, A., Vikström, M., Stevens, A., Haga, N., de Jong, J. R., & Goossens, M. E. J. B. (2014) · European Journal of Pain · doi:10.1002/ejp.592 · Cited by 22 · see citing works
Ye, D.-L., Plante, I., Roy, M., Ouellet, J. A., & Ferland, C. E. (2020) · Physical & Occupational Therapy In Pediatrics · doi:10.1080/01942638.2020.1720054 · Cited by 22 · see citing works
Gait Variability and Relationships With Fear, Avoidance, and Pain in Adolescents With Chronic Pain
Beebe, J. A., Kronman, C. A., Mahmud, F., Basch, M. C., Hogan, M., Li, E., Ploski, C., & Simons, L. E. (2021) · Physical Therapy · doi:10.1093/ptj/pzab012 · Cited by 22 · see citing works
Self-citationIdentifying subgroups of paediatric chronic pain patients: A cluster‐analytic approach
Wager, J., Zernikow, B., Darlington, A., Vocks, S., & Hechler, T. (2014) · European Journal of Pain · doi:10.1002/j.1532-2149.2014.497.x · Cited by 22 · see citing works
Flack, F., Gerlach, A. L., Simons, L. E., Zernikow, B., & Hechler, T. (2017) · European Journal of Pain · doi:10.1002/ejp.1022 · Cited by 22 · see citing works
Self-citationMaking Sense of “Somatization”: A Systematic Review of its Relationship to Pediatric Pain
Boerner, K. E., Green, K., Chapman, A., Stanford, E., Newlove, T., Edwards, K., & Dhariwal, A. K. (2019) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsz102 · Cited by 20 · see citing works
Walker, L. S. (2019) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsz050 · Cited by 20 · see citing works
Simons, L. E., Harrison, L. E., Boothroyd, D. B., Parvathinathan, G., Van Orden, A. R., O'Brien, S. F., Schofield, D., Kraindler, J., Shrestha, R., Vlaeyen, J. W. S., et al. (2024) · Pain · doi:10.1097/j.pain.0000000000003010 · Cited by 19 · see citing works
Self-citationRapid Screening of Risk in Pediatric Headache: Application of the Pediatric Pain Screening Tool
Heathcote, L. C., Rabner, J. C., Lebel, A., Hernandez, J. M., & Simons, L. E. (2017) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsx123 · Cited by 18 · see citing works
Self-citationLogan, D. E., Donado, C., Kaczynski, K. J., Lebel, A., & Schechter, N. L. (2021) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000939 · Cited by 18 · see citing works
Self-citationDutch version of the Fear of Pain Questionnaire for adolescents with chronic pain
Dekker, C., Bastiaenen, C. H. G., de Vries, J., Simons, L. E., Goossens, M. E. J. B., & Verbunt, J. (2017) · Disability and Rehabilitation · doi:10.1080/09638288.2017.1289255 · Cited by 17 · see citing works
Self-citationSollerhed, A., Andersson, I., & Ejlertsson, G. (2013) · European Journal of Sport Science · doi:10.1080/17461391.2013.767946 · Cited by 17 · see citing works
Fear in Pediatric Acute Pain: Role and Measurement
Bird, L., & McMurtry, C. M. (2012) · Pain Management · doi:10.2217/pmt.12.56 · Cited by 17 · see citing works
Multidisciplinary treatment for hypermobile adolescents with chronic musculoskeletal pain
Meulenbroek, T., Conijn, A., Huijnen, I., Engelbert, R., & Verbunt, J. (2020) · Journal of Rehabilitation Medicine – Clinical Communications · doi:10.2340/20030711-1000033 · Cited by 16 · see citing works
Mbazzi, F. B., Nimusiima, C., Akellot, D., Kawesa, E. S., Abaasa, A. M., Hodges, S., Seeley, J., & Vervoort, T. (2021) · Pain Medicine · doi:10.1093/pm/pnab206 · Cited by 16 · see citing works
Wildeboer, E. M., Chambers, C. T., Soltani, S., & Noel, M. E. (2023) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000001108 · Cited by 16 · see citing works
Han, G. T., Heavner, H. S., Rains, T., Hoang, A. H., & Stone, A. L. (2024) · Children · doi:10.3390/children11030312 · Cited by 16 · see citing works
The Experience of Adolescents Living With Headache
Walter, S. M. (2017) · Holistic Nursing Practice · doi:10.1097/hnp.0000000000000224 · Cited by 16 · see citing works
Precipitating events in child and adolescent chronic musculoskeletal pain
Becker, A. J., Heathcote, L. C., Timmers, I., & Simons, L. E. (2018) · PAIN Reports · doi:10.1097/pr9.0000000000000665 · Cited by 16 · see citing works
Self-citationLemme, J. D., Holmes, S. A., Sibai, D., Mar’i, J., Simons, L. E., Burstein, R., Zurakowski, D., Lebel, A., O’Brien, M. J., Upadhyay, J., et al. (2020) · Journal of Neurotrauma · doi:10.1089/neu.2020.7189 · Cited by 16 · see citing works
Self-citationMcGarrigle, L., Wesson, C., Amicis, L. D., Connoly, S., & Ferreira, N. B. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2020.10.009 · Cited by 16 · see citing works
Ceniza-Bordallo, G., Fraile, A. G., Martín‐Casas, P., Rabbitts, J. A., Li, R., Palermo, T. M., & López‐de‐Uralde‐Villanueva, I. (2024) · Pain · doi:10.1097/j.pain.0000000000003330 · Cited by 17 · see citing works
Dekker, C., Goossens, M. E. J. B., Winkens, B., Remerie, S. C., Bastiaenen, C. H. G., & Verbunt, J. (2020) · Children · doi:10.3390/children7120288 · Cited by 14 · see citing works
Rosenbloom, B. N., Slepian, P. M., Pagé, M. G., Isaac, L., Campbell, F. A., Stinson, J., & Katz, J. D. (2021) · Children · doi:10.3390/children8050360 · Cited by 15 · see citing works
Beeckman, M., Simons, L. E., Hughes, S., Loeys, T., & Goubert, L. (2019) · Pain Medicine · doi:10.1093/pm/pnz211 · Cited by 15 · see citing works
Self-citationPintó, P. B., Ickmans, K., Rheel, E., Iwens, M., Meeus, M., Nijs, J., & Pas, R. (2021) · Children · doi:10.3390/children8050420 · Cited by 15 · see citing works
Simons, L. E., Pielech, M., McAvoy, S., Conroy, C., Hogan, M., Verbunt, J. A., & Goossens, M. E. (2017) · Pain · doi:10.1097/j.pain.0000000000000855 · Cited by 14 · see citing works
Self-citation
- Authors
- Simons, L. E., Sieberg, C. B., Carpino, E., Logan, D., & Berde, C.
- Affiliations
- Boston Children's Hospital (US)
- Corresponding author
- Simons, Laura E.
- Venue
- The Journal of Pain
- Publisher
- Elsevier BV
- Published
- 2011-06
- Volume
- 12
- Issue
- 6
- Pages
- 677-686
- ISSN
- 1526-5900 (ISSN-L)
- OpenAlex
- W2073573551
- Cited by
- 235
- References
- 44
- Citations by year
- 2026: 17 · 2025: 18 · 2024: 16 · 2023: 15 · 2022: 19 · 2021: 18 · 2020: 19 · 2019: 24 · 2018: 8 · 2017: 14 · 2016: 15 · 2015: 9 · 2014: 14 · 2013: 12 · 2012: 14
- FWCI
- 12.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- fear of pain, chronic pain, pediatric chronic pain, adolescents, children, fear-avoidance beliefs, psychometric validation, parent proxy reporting, pain-related disability, pain catastrophizing, somatization, multidisciplinary pain management
- MeSH terms
- Adolescent, Anxiety, Avoidance Learning, Child, Fear, Female, Humans, Male, Predictive Value of Tests, Surveys and Questionnaires, Stress, Psychological, Chronic Pain
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