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Development and Validation of a Daily Pain Catastrophizing Scale
Open accessAbstract
To date, there is no validated measure for pain catastrophizing at the daily level. The Pain Catastrophizing Scale (PCS) is widely used to measure trait pain catastrophizing. We sought to develop and validate a brief, daily version of the PCS for use in daily diary studies to facilitate research on mechanisms of catastrophizing treatment, individual differences in self-regulation, and to reveal the nuanced relationships between catastrophizing, correlates, and pain outcomes. After adapting the PCS for daily use, we evaluated the resulting 14 items using 3 rounds of cognitive interviews with 30 adults with chronic pain. We refined and tested the final daily PCS in 3 independent, prospective, cross-sectional, observational validation studies conducted in a combined total of 519 adults with chronic pain who completed online measures daily for 14 consecutive days. For study 1 (N = 131), exploratory factor analysis revealed adequate fit and-unexpectedly-unidimensionality for item responses to the daily PCS. Study 2 (N = 177) correlations indicated adequate association with related constructs (anger, anxiety, pain intensity, depression). Similarly, results for study 3 (N = 211) revealed expected correlations for daily PCS and measures of daily constructs including physical activity, sleep, energy level, and positive affect. Results from complex/multilevel confirmatory factor analysis confirmed good fit to a unidimensional model. Scores on the daily PCS were statistically comparable with and more parsimonious than the full 14-item version. Next steps include evaluation of score validity in populations with medical diagnoses, greater demographic diversity, and in patients with acute pain.Perspective This article describes the development and validation of a daily PCS. This daily measure may facilitate research that aims to characterize pain mechanisms, individual differences in self-regulation, adaptation, and nuanced relationships between catastrophizing, correlates, and pain outcomes.
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“pain catastrophising item are based on the Pain Catastrophising Scale,64”
From Development, evaluation and implementation of a digital behavioural health treatment for chronic pain: study protocol of the multiphase DAHLIA project (2022) · cites this paper as [64]
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Additional file 1 of Anterior cingulate cortex regulates pain catastrophizing-like behaviors in rats
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“…a systematic process: (1) reviewing existing catastrophic thinking literature and clinical measures of catastrophizing (Crombez et al., 2020; Darnall et al., 2017; Laraki et al., 2023; Petrini & Arendt-Nielsen, 2020; Pike et al., 2021; Sullivan et al., 1995), (2) conducting focus groups…”
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“The Pain Catastrophizing Scale (PCS) is a 13-item self-report measure of catastrophizing in the context of actual or anticipated pain [71], and its items are scored from 0 (not at all) to 4 (all the time) on a 4-point scale [72–75].”
Zhao, J., Chen, M., Schreiber, K. L., Wilson, J. M., Grahl, A., DeForge, S. M., Bulls, H. W., Edwards, R. R., Allsop, M. J., Businelle, M. S., et al. (2026) · JCO Oncology Practice · doi:10.1200/op-25-01124 · Cited by 1
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“Other commonly used tools include the Fear-Avoidance Beliefs Questionnaire (FABQ) [20, 21] and the Pain Catastrophizing Scale (PCS) [22].”
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“The PCS is a validated, 13-item patient-reported questionnaire that is used to quantify maladaptive pain-related cognitions (rumination, magnification, and helplessness) [15].”
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“25 This is particularly relevant for important constructs in chronic pain such as psychological flexibility and acceptance, 11 which are expected to fluctuate over time 26 and thus may be insufficiently captured by retrospective, group-level assessments.”
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“Preoperative psychological status was assessed using the Hospital Anxiety and Depression Scale (HADS) [16] and Pain Catastrophizing Scale (PCS) [17].”
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“17 The items chosen were the analogue of the 3 items of the Pain Catastrophizing Scale previously validated as a 3-item daily composite in adults with chronic pain 12 and represented each of the 3 primary components of PC: rumination (ie, “I keep thinking about how much my child hurts.”)”
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“Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale, whereas pain catastrophizing was assessed using the Short-Form Pain Catastrophizing Scale (SF-PCS) (21, 22).”
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Metadata
- Authors
- Darnall, B. D., Sturgeon, J. A., Cook, K. F., Taub, C. J., Roy, A., Burns, J. W., Sullivan, M., & Mackey, S. C.
- Affiliations
- Stanford Medicine (US)
- Northwestern University (US)
- Rush University (US)
- The University of Queensland (AU)
- Corresponding author
- Darnall, Beth D.
- ORCID
- Venue
- The Journal of Pain
- Publisher
- Elsevier BV
- Published
- 2017-09
- Volume
- 18
- Issue
- 9
- Pages
- 1139-1149
- ISSN
- 1526-5900 (ISSN-L)
- PMC
- PMC5581222
- OpenAlex
- W2614350387
- Cited by
- 264
- References
- 35
- Citations by year
- 2026: 36 · 2025: 58 · 2024: 38 · 2023: 38 · 2022: 38 · 2021: 31 · 2020: 17 · 2019: 6 · 2018: 1 · 2017: 1
- FWCI
- 4.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (K24DA029262, K24DA053564, T32DA035165, HHSN271201200728P)
- National Center for Complementary and Integrative Health (P01AT006651, R01AT008561)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Keywords
- pain catastrophizing, chronic pain, scale development, cognitive interviewing, unidimensionality, factor structure, self-regulation, pain mechanisms, pain intensity, sleep, physical activity, positive affect
- MeSH terms
- Adult, Cross-Sectional Studies, Delphi Technique, Factor Analysis, Statistical, Female, Humans, Interviews as Topic, Male, Medical Records, Middle Aged, Prospective Studies, Psychiatric Status Rating Scales, Psychometrics, Time Factors, Qualitative Research, Multilevel Analysis, Catastrophization, Chronic Pain
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