Cited by 202Musculoskeletal pain and rehabilitationPediatric Pain Management TechniquesPain Management and Opioid Use

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Pain-coping strategies in chronic pain patients: Psychometric characteristics of the pain-coping inventory (PCI)

Kraaimaat, Floris W., Evers, Andrea W. M.·2003·International Journal of Behavioral Medicine

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Abstract

This article presents a series of studies aimed at validating a comprehensive pain-coping inventory (PCI) that is applicable to various types of patients with chronic pain. Item and scale analyses were performed for patients with rheumatoid arthritis (RA), patients with chronic headache, and pain clinic outpatients. The following 6 scales were derived from a simultaneous component analysis: Pain Transformation, Distraction, Reducing Demands, Retreating, Worrying, and Resting, all of which were internally reliable. A higher order factor analysis grouped the PCI scales into active (transformation, distraction, reducing demands) and passive (retreating, worrying, resting) pain-coping dimensions. Differences in use of strategy found between RA patients and headache patients indicated that the PCI scales were sufficiently sensitive to measure differences between groups. Concurrent validity was assessed for patients with RA and patients with fibromyalgia and predictive validity was assessed for patients with recently diagnosed RA after 1 and 3 years. In both analyses the validity of the scales was supported, in particular the predictive validity of passive coping scales for future outcomes.

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9 Reumatische aandoeningen
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“16 Sleep disturbance has been linked to increased disability among individuals with headache 14,17 and poorer pain coping, 18 and may be a mechanism involved in headache chronification.”
The association between personality, coping, and depression in patients with chronic pain
Deif, R., & Ellis, K. (2019) · Egyptian Journal of Psychiatry · doi:10.4103/ejpsy.ejpsy_12_19 · Cited by 2
“PCI items are classified into six factors based on the factor loadings and internal consistencies demonstrated by Kraaimaat and Evers (2003).”
Method
Chronic pain treatment: from psychological predictors to implementation.
Samwel, H. J. A. (2008) · Radboud Repository (Radboud University) · Cited by 2
The Coping Strategies Questionnaire: Translation, cultural adaptation, reliability and validity in Turkish-speaking patients with chronic musculoskeletal pain
Sözlü, U., Kanık, Z. H., Günaydın, G., Alkan, Z. B., Pala, Ö. O., Başar, S., Çıtaker, S., & Kanatlı, U. (2021) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2021.1989732 · Cited by 1
“Patients with chronic pain use a variety of behavioral and cognitive abilities, called pain coping strategies to cope with these problems (Jensen, Turner, Romano, and Karoly, 1991; Kraaimaat and Evers, 2003).”
Background
Investigating the interplay of chronic pain intensity and psychosocial factors in adult women: A pilot study from Türkiye
Yıldırım, B., İşler, A. M., Oral, M., Peksen, H., Cıceklıyurt, S., Kılıç, C., Karapınar, D. Ç., & Aydogan, F. N. (2024) · Health Care For Women International · doi:10.1080/07399332.2024.2402734 · Cited by 1
“The Pain Coping Inventory was developed by Kraaimaat and Evers (2003) to identify the behavioral and cognitive strategies used by patients with chronic pain to cope with pain.”
Can physical and psychological factors predict pain recurrence or an exacerbation of persistent non-specific low back pain? A protocol for a systematic review and meta-analysis
Wongwitwichote, K., Yu, C. W. G., Mansfield, M., Deane, J. A., & Falla, D. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-096594 · Cited by 1
‘A post-test experimental study on the effects of message framing and the use of a patient testimonial on intentions of osteoarthritis patients to adhere to treatment advice’
Oomen, J. M. H., van den Ende, C. H. M., Schers, H., Koëter, S., Assendelft, W. J., & Das, E. H. H. J. (2025) · BMC Public Health · doi:10.1186/s12889-025-22436-6 · Cited by 1
“It comprises 5 items consisting of 4-point Likert scales (hardly ever – very often) and showed high reliability and validity in a previous study [38].”
EFFECT OF PAIN COPING STRATEGIES V/S KINESTHESIA, BALANCE AND AGILITY EXERCISES IN CHRONIC KNEE OA: A CLINICAL TRIAL
Hotwani, R., Shah, S., & Keswani, S. (2019) · International Journal of Physiotherapy and Research · doi:10.16965/ijpr.2019.150 · Cited by 1
“Cognitive and behavioral reactions to pain are significant because they may affect pain, functional capacity, psychological functioning and may be amenable to change brought about by intervention [6].”
Background
Yaşlı bireylerin kronik ağrıyla baş etme durumları ve etkileyen faktörlerin incelenmesi
Karaman, E., Kasar, K. S., & Kankaya, H. (2021) · Ege Tıp Dergisi · doi:10.19161/etd.1037456 · Cited by 1
“İyi Orta Kötü 20 (20,6) 58 (59,8) 19 (19,6) 2,03±0,61 1,89±0,42 1,90±0,39  2 = 0,522** p= 0,770 2,34±0,80 2,52±0,49 2,89±0,62  2 = 8,533** p= 0,014”
Influential
Central Sensitisation Syndrome: A Frequent Finding in Women with Pelvic Floor Symptoms Without Evident Urogenital Prolapse
Vermeulen, C. K. M., Tunnissen, W., Coolen, A.-L. W. M., Veen, J., Dietz, V., van Leijsen, S. A. L., & Bongers, M. Y. (2024) · International Urogynecology Journal · doi:10.1007/s00192-023-05697-w · Cited by 1
“The Pain Coping Inventory (PCI) [11] is a validated tool for analysing coping strategies, differentiating between active and passive coping through 33 items.”
Physical and psychological predictors for persistent and recurrent non-specific neck pain: a protocol for a systematic review and meta-analysis
Yu, C. W. G., Wongwitwichote, K., Mansfield, M., Deane, J. A., & Falla, D. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-094967 · Cited by 1
“Psychological predictors will be scores from questionnaires measuring common reported psychological characteristics including but not limited to the Tampa Scale for Kinesiophobia, 41 Patient Self-Efficacy Questionnaire, 42 Pain Coping Inventory 43 and the European Quality of Life-5 Dimensions.”
At-Home Virtual Reality Intervention for Patients With Chronic Musculoskeletal Pain: Single-Case Experimental Design Study
Slatman, S., Heesink, L., Achterkamp, R., Broeks, J., de Oliveira, N. P. M., ter Riet, R., Stegeman, M., & Tabak, M. (2025) · JMIR XR and spatial computing. · doi:10.2196/58784 · Cited by 1
“These questionnaires were the Dutch translation of the original questionnaires, and all were shown to have adequate reliability and validity [29-31].”
ACTIVE OR PASSIVE PAIN COPING STRATEGIES AMONG PARTICIPANTS BEFORE HIP SCHOOL
Hansson, M., & Klässbo, M. (2017) · DiVA (Linnaeus University) · doi:10.82161/f39f-8d02 · Cited by 1
Work-related complaints in the upper extremity : prevention and treatment
Meijer, E. M. (2006) · UvA-DARE (University of Amsterdam) · Cited by 1
Understanding and treating hand osteoarthritis: a challenge
Stukstette, M. J. P. M. (2013) · Utrecht University Repository (Utrecht University) · Cited by 1
BABS on a mission: An experimental study on the effects of message framing and the use of a patient testimonial on intentions of osteoarthritis patients to adhere to treatment advicePreprint
Oomen, J. M. H., van den Ende, C. H. M., Schers, H., Koëter, S., Assendelft, W. J., & Das, E. H. H. J. (2023) · Research Square · doi:10.21203/rs.3.rs-2701276/v1 · Cited by 1
Cognitive behavioural treatment programme for chronic neuropathic pain after spinal cord injury
Matagne Heutink, B. (2014) · Utrecht University Repository (Utrecht University)
The effect of fear of pain on rehabilitation of acute musculoskeletal injury
Legge, L. (2010) · Spectrum Research Repository (Concordia University)
The burden of hip and knee complaints
van der Waal, J. M. (2005) · Data Archiving and Networked Services (DANS)
A burning matter: Investigations into inflammation and central sensitization in CRPS
Fischer, S. G. L. (2014) · Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam)
De psycholoog als pijnbehandelaar: de weg gegaan en te gaan
Samwel, H. J. A. (2006) · Bijblijven · doi:10.1007/bf03059976
Predicting Disability, Pain and Work Capacity after Surgery for a Lumbosacrale Radicular Syndrome.
den Boer, J. J. (2008) · Radboud Repository (Radboud University)
Characteristics of Coping Strategies for Dysesthesia in Preoperative Patients with Compressive Cervical Myelopathy
Higuchi, D. (2014) · Asian Spine Journal · doi:10.4184/asj.2014.8.4.393
De rol van repetitieve negatieve gedachten bij chronische pijn
Karsdorp, P. A., Vlaeyen, J. W. S., & Crombez, G. (2012) · Lirias
Tese apresentada com vistas à obtenção do título de Doutor em Ciências na área de Epidemiologia em Saúde Pública.
Souza, I. (2015)
Befund und Therapie von Schleudertrauma-Patienten
Carvalho, G. F. (2020) · Der Schmerzpatient · doi:10.1055/a-1157-3163
“Pain-coping strategies in chronic pain patients: psychometric characteristics of the pain-coping inventory (PCI).”
Background
Het ontwikkelen en evalueren van het online zelfmanagementprogramma ‘Reuma zelf te lijf ’
Zuidema, R. (2021) · Verpleegkunde · doi:10.24078/vpg.2021.3.126593
The Correlation Between Spiritual Health With the Coping Ability of the Clients Towards the Pain in the Labour Process Within the Work Area of Ibrahim Adjie’s Community Center in Bandung 2019
Sukmayati, M. (2021) · Advances in Social Science, Education and Humanities Research/Advances in social science, education and humanities research · doi:10.2991/assehr.k.210304.071
Exploratory Study of Associations and Agreement between Prognostic Patient-Registered Factors, Physiotherapists’ Intuitive Synthesis, and Patient-Reported Factors in Whiplash-Associated Disorders
Oostendorp, R. A. B., Scholten-Peeters, G. G. M., Mulder, J., van Trijffel, E., Rutten, G. M., Kooning, M. D., Laekeman, M., Roussel, N. A., Nijs, J., & Elvers, J. W. H. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12062330 · Cited by 1
Clinical Scales for Psychiatric Comorbidities and Cognitive Processes in Headache and Migraine
Caponnetto, V., Rosignoli, C., & Sacco, S. (2023) · Headache · doi:10.1007/978-3-031-25938-8_9
BABS (Becoming Active in Beating osteoarthritiS): Study protocol of a randomized controlled trial on the effectiveness of an information campaign in improving the management of osteoarthritis and quality of carePreprint
Oomen, J. M. H., Schers, H., Das, E. H. H. J., Koëter, S., van den Ende, C. H. M., & Assendelft, W. J. (2023) · Research Square · doi:10.21203/rs.3.rs-2790579/v1
ปจจยคดสรรทสมพนธกบคณภาพชวตดานสขภาพของผปวยโรคเกาท
อ่วมตานี, ป. (2019) · doi:10.58837/chula.the.2019.1022
Pain and Related Coping Strategies among Patients with Peripheral Arterial Occlusive Disease
David, R. D. S. (2023) · International Journal of Science and Research (IJSR) · doi:10.21275/sr23501094528
Onkoloji Kliniğinde Yatan 18-65 Yaş Arası Hastaların Ağrıyla Baş Etme Yöntemlerinin Belirlenmesi
Ordu, Y. (2024) · Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi · doi:10.37989/gumussagbil.1367604
Pelvic floor dysfunction in women after hysterectomy
Vermeulen, C. K. M. (2024) · Research Publications (Maastricht University) · doi:10.26481/dis.20241204cv
THE RELATIONSHIP BETWEEN PROBLEM SOLVING AND COPING WITH CHRONIC MUSCULOSKELETAL PAIN IN MEDICAL STUDENTS: A CROSS-SECTIONAL STUDY
Keskin, D., Efe, M. F., Öztaş, N. N., Kankal, S., Oğuz, S., Çit, M. U., & Köroğlu, M. T. (2024) · Kırıkkale Üniversitesi Tıp Fakültesi Dergisi · doi:10.24938/kutfd.1553848
The Role of Pain Catastrophizing in The Pain and Functions of Young and Older Patients with Knee Osteoarthritis
Parpucu, T. İ., Karapınar, M., Başkurt, Z., & Başkurt, F. (2025) · Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi · doi:10.22312/sdusbed.1536685
Cognitive Intrusion, Pain Coping and Quality of Life in Hemodialysis Patients.
Doğan, R., Mercan, N., Kahraman, B. B., & Kara, A. (2025) · Pain Management Nursing · doi:10.1016/j.pmn.2025.07.003
Kinesiophobia and Pain Coping on Patients with Gonarthrosis: Postoperative Pain and Mobility
Şenol, T., & Çelik, S. (2025) · Pain Management Nursing · doi:10.1016/j.pmn.2025.12.008
The Association Between Pain Characteristics, Psychological Aspects, Functional Disability and Postural Sway in Individuals with Nonspecific Chronic Low Back Pain: The Preliminary Study
Adnan, R., Anuwar, S. S., Dzulkapli, D. Z., Man, S. N. E. C., Ismail, H. H., Mazuki, M. S., Arayama, M., Sulaiman, N., Ismail, H., Razalli, M. M., et al. (2026) · Lecture notes in bioengineering · doi:10.1007/978-981-95-0804-4_48
BABS (Becoming Active in Beating osteoarthritiS): a cluster randomized controlled trial evaluating an information campaign to improve osteoarthritis care and management in Dutch general practices
Oomen, J. M. H., Schers, H. J., Das, E., Assendelft, W. J., Koëter, S., & den Ende, C. H. V. (2026) · BMC Family Practice · doi:10.1186/s12875-025-03162-9 · Cited by 1
“…Rating Scale; NRS), daily functioning (Lower Extremity Functional Scale; LEFS) [23, 24], pain-coping (pain coping inventory; PCI, resting subscale) [25], physical activity (International Physical Activity Questionnaire—Short Form; IPAQ-SF) [26], healthcare use (type of HCPs visited (GP, PT or…”
Coping strategies used by individuals with chronic orofacial pain: A qualitative study
Kanaya, M. R., Fishbein, N. S., Bakhshaie, J., & Greenberg, J. (2026) · Journal of Health Psychology · doi:10.1177/13591053261429011
“Numerous self-report questionnaires have been developed to assess coping in chronic pain (Bond et al., 2012; Carver, n.d.; Jensen et al., 1995; Kraaimaat and Evers, 2003; Rosenstiel and Keefe, 1983; Sullivan et al., n.d) with some, albeit limited, use among individuals with chronic orofacial pain…”
Development of Data-Driven Models for Just-in-Time Digital Self-Management Advice to Improve Physical Functioning in Hip and Knee Osteoarthritis: Protocol for the e-cOAch Cross-Over Study
Groen, F., de Rooij, M., Kloek, C. J. J., Veenhof, C., Klein, M. C. A., Al-Janabi, A., van Haeringen, E. S., Ronteltap, A., Cijs, B., van Dongen, B., et al. (2026) · JMIR Research Protocols · doi:10.2196/94709
“The PCI j [46].”
A Mixed‐Methods Analysis of Pain Catastrophizing and Coping Mechanisms Among Nursing Students: An Explanatory Perspective
Şahin, N. D., & Aslan, Z. (2026) · Perspectives In Psychiatric Care · doi:10.1155/ppc/5400659
Clinical indicators associated with pain trajectories in non-specific neck pain: a secondary analysis of a multicentre prospective observational cohort to develop a clinical compass for personalised physiotherapy in primary care
Verwoerd, M. J., Felius, R. A. W., Konings, S., Kiers, H., & Smeets, R. (2026) · BMJ Open · doi:10.1136/bmjopen-2025-115274
Physical and Psychological Features During Remission From Non‐Specific Neck Pain
Yu, C. W. G., Wongwitwichote, K., Deane, J. A., Devecchi, V., Mansfield, M., & Falla, D. (2026) · European Journal of Pain · doi:10.1002/ejp.70365
“…three active coping strategies (pain transformation, distraction, reducing demands) and three passive coping strategies (retreating, worrying, resting) (Kraaimaat and Evers 2003); and the European Quality of Life—Visual Analog Scale (EQ-VAS) to assess health-related quality of life (Brooks 1996).”
Development and validation of the rest experience scale for adults with chronically fatiguing conditions
Ackah, M., Abonie, U. S., Hettinga, F. J., Hackett, K. L., & Deary, V. (2026) · PLoS ONE · doi:10.1371/journal.pone.0355730
“This construct corroborates with the existing rest sub-scale found within the CPCI and other pain coping inventories [33,34,62], suggesting a conceptual consistency and underpinned by the energy conservation theory [63].”

Authors: Kraaimaat, F. W., & Evers, A. W. M.
Affiliations: Radboud University Nijmegen (NL)
Corresponding author: Kraaimaat, Floris W.
ORCID: Evers, Andrea W. M.
Venue: International Journal of Behavioral Medicine
Publisher: Springer Science and Business Media LLC
Published: 2003-12
Volume: 10
Issue: 4
Pages: 343-363
ISSN: 1070-5503 (ISSN-L)
1532-7558
DOI: 10.1207/s15327558ijbm1004_5
OpenAlex: W1969226151
Cited by: 202
References: 54
Citations by year: 2026: 11 · 2025: 13 · 2024: 11 · 2023: 13 · 2022: 4 · 2021: 7 · 2020: 7 · 2019: 10 · 2018: 8 · 2017: 8 · 2016: 12 · 2015: 6 · 2014: 9 · 2013: 15 · 2012: 9
FWCI: 3.73
Type: journal article
Language: en
Open access: closed
Locations: International Journal of Behavioral Medicine (publishedVersion)
PubMed (publishedVersion)
Radboud Repository (Radboud University) (submittedVersion)
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
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords: pain coping, chronic pain, rheumatoid arthritis, chronic headache, fibromyalgia, psychometric validation, distraction, worry, rest, concurrent validity, predictive validity
MeSH terms: Adaptation, Psychological, Adult, Arthritis, Rheumatoid, Chronic Disease, Fibromyalgia, Headache, Humans, Middle Aged, Pain, Pain Measurement, Psychometrics, Reproducibility of Results, Principal Component Analysis

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Pain-coping strategies in chronic pain patients: Psychometric characteristics of the pain-coping inventory (PCI)

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