Pain Beliefs and Perceptions Inventory: A Cross-Sectional Study in Chronic and Episodic Migraine

Classification of pain intensity with the pain beliefs and perceptions inventory (PBPI) and the pain catastrophizing scales (PCS)

PURPOSE

The pain beliefs and perceptions inventory (PBPI) and the pain catastrophizing scales (PCS) characterize beliefs or distress dimensions of the pain experience. It is relatively unknown, however, to what degree the PBPI and the PCS are well suited to classifying pain intensity.

METHODS

This study applied a receiver operating characteristic (ROC) approach to these instruments against the criterion of a visual analogue scale (VAS) of pain intensity with fibromyalgia and chronic back pain patients (n = 419).

RESULTS

The largest areas under the curve (AUC) were moderate and limited to the constancy subscale (71%) and total score (70%) of the PBPI and to the helplessness subscale (75%) and total score (72%) of the PCS. The best cut-off scores for the PBPI and PCS were better off at detecting true negatives than true positives, with larger specificity than sensitivity values.

CONCLUSION

Whereas, the PBPI and PCS are certainly useful instruments to evaluate diverse pain experiences, they may be inappropriate to classify intensity. The PCS performs marginally better than the PBPI for classifying pain intensity.

Validity and reliability of the Greek version of the Pain Beliefs and Perceptions Inventory for patients with chronic pain

Background/aims

The Pain Beliefs and Perceptions Inventory has been used widely to evaluate pain perceptions and beliefs of patients with chronic pain. This is a cross-cultural adaptation of the instrument into Greek. The purpose of the study was to investigate: the face and content validity; the factor structure; the concurrent validity; the discriminant validity; and the internal consistency and the test–retest reliability of the Pain Beliefs and Perceptions Inventory for people with chronic pain.

Methods

A total of 174 patients with chronic low back pain, neck pain and/or pain of limbs lasting for at least 6 months and with a physiotherapy referral participated in the study. Exploratory factor analysis by a principal axis factoring with direct oblimin rotation was chosen to examine the factor structure of the Pain Beliefs and Perceptions Inventory. The concurrent validity was assessed using correlations by Spearman's rho correlation coefficient among the Pain Beliefs and Perceptions Inventory and the Short Form-McGill Pain Questionnaire, the Present Pain Index, the visual analogue scale and the Brief Pain Inventory. The discriminant validity was examined by Spearman's rho correlation coefficient among the Pain Beliefs and Perceptions Inventory and Social Desirability Scale. The reliability of the instrument was examined using Cronbach's α internal consistency coefficients and intraclass correlation coefficients.

Results

Exploratory factor analysis confirmed the four factor structure of the Pain Beliefs and Perceptions Inventory that explained 66.353% of the total variance. Concurrent validity was determined through examination of correlations between the Pain Beliefs and Perceptions Inventory and other validated constructs (eg Short Form-McGill Pain Questionnaire Affective factor with Total Pain Beliefs and Perceptions Inventory Spearman's rho=0.257, P<0.001, Brief Pain Inventory General Activity and Pain Beliefs and Perceptions Inventory Constancy factor Spearman's rho=0.522, P<0.05, Brief Pain Inventory relations with other people and Pain Beliefs and Perceptions Inventory Constancy factor Spearman's rho=0.512, P<0.05). The discriminant validity of the Pain Beliefs and Perceptions Inventory was confirmed by examining correlations between the Pain Beliefs and Perceptions Inventory with the Marlowe–Crowne Social Desirability Scale. The questionnaire was internally consistent (α=0.89–0.96) and its stability was good (intraclass correlation coefficients=0.73–0.82).

Conclusions

The Greek translation of the Pain Beliefs and Perceptions Inventory is a reliable and valid instrument to evaluate Greek patients with chronic pain.

Pain appraisal and quality of life in 108 outpatients with rheumatoid arthritis

Individual differences in emotional functioning, pain appraisal processing, and perceived social support may play a relevant role in the subjective experience of pain. Due to the paucity of data regarding individuals with Rheumatoid Arthritis (RA), the present study aimed to examine pain intensity, emotional functioning (psychological distress and alexithymia), pain appraisal (pain beliefs, pain catastrophizing, and pain-related coping strategies) and social support, and their relationships with the health-related quality of life (HRQoL) in patients with RA. Data were collected from 108 female patients diagnosed with RA. Clinically relevant levels of depressive and anxiety symptoms assessed by the HADS subscales were present in 34% and 41% of the patients, respectively, and about 24% of them exhibited the presence of alexithymia. The results of hierarchical multiple regression analyses showed that pain intensity, alexithymia, the maladaptive beliefs regarding the stability of pain and the coping strategy of guarding explained 54% of the variance in the physical component of HRQoL (p < 0.001). Depression subscale of the HADS, alexithymia, the coping strategy of resting, and the rumination factor of pain catastrophizing significantly explained 40% of the variance in the mental component of HRQoL (p < 0.001). The present findings provide evidence regarding the importance of emotional functioning and pain appraisal in the negative impact of RA on patients' quality of life. These findings provide additional evidence for the biopsychosocial model of chronic pain, further supporting the complex interaction between emotional, cognitive, and behavioral processes in patients with chronic pain.

The Relationship Between Self-Blame for the Onset of a Chronic Physical Health Condition and Emotional Distress: A Systematic Literature Review

OBJECTIVE

Past literature presents contrasting perspectives regarding the potential influence of self-blame on adjustment to illness. This systematic literature review aimed to summarize findings from all investigations to date that have explored the relationship between self-blame for the onset of a chronic physical health condition and emotional distress.

METHOD

Between November 2014 and February 2015, electronic databases were searched for relevant literature. Only those studies which assessed self-blame directly and related specifically to illness onset were included within the review. The methodological and reporting quality of all eligible articles was assessed, and themes within the findings were discussed using a narrative synthesis approach.

RESULTS

The majority of studies found self-blame to be associated with increased distress. However, several concerns with the quality of the reviewed articles may undermine the validity of their conclusions.

CONCLUSIONS

It is important for professionals supporting people with chronic physical health conditions to have an understanding of how of self-critical causal attributions might relate to emotional distress. Further research is required to understand the concept of self-blame, the factors that may encourage this belief and to develop reliable and valid measures of this experience. Copyright © 2016 John Wiley & Sons, Ltd.

KEY PRACTITIONER MESSAGE

What does this study add? The review presents an exploration of the role of self-blame in emotional adjustment following the diagnosis of a chronic physical health condition. This is the first review to synthesize findings from studies measuring self-blame beliefs directly and specifically for illness onset and their relationship to indicators of distress and wellbeing. Findings suggest that self-blame for illness onset is often associated with emotional distress for people with cancer, HIV/AIDS and cardiovascular disease. This has implications for how healthcare professionals respond to self-blaming beliefs in the context of illness. Research quality concerns are identified for many of the reviewed studies, highlighting a need for further research on this topic.