A Factor Analytic Study of Pain Catastrophizing Items

Abstract

Pain catastrophizing refers to an exaggerated negative mental set during the actual or anticipated experience of pain (Sullivan, Bishop, & Pivik, 1995). Interest in this construct, promising research findings, and greater attention to the role of psychological mechanisms in pain perception has led to a proliferation of self-report measures for assessing pain catastrophizing. Sullivan and colleagues’ (1995) three-factor Pain Catastrophizing Scale (PCS) is the most widely employed today. However, currently the construct is somewhat vaguely defined, different measures utilize different conceptual models, and many similar constructs exist. Similar to Brenan, Clark, and Shaver (1998) we gathered all available measures tapping pain catastrophizing and similar constructs, eliminated a small number of clearly redundant items, and had a sample of respondents (who regularly experience pain) complete a questionnaire containing the items. Items reflecting resilience were also included in the final questionnaire. This 70-item questionnaire was administered via the crowdsourcing platform: Mechanical Turk. This approach allowed us to assess the stability of the three-factor solution proposed by the PCS, to explore alternative models, and to develop a new measure based on these findings. Exploratory factor analyses (EFA) of just the items from the PCS did not yield a replication of the three-factor structure and instead found support for a one-factor model which accounted for 46.42% of the overall variance. EFA of the full item pool found support for a 45-item, five-factor model which accounted for 52.98% of the total variance and had no commonalities lower than 0.30. The following subscales were derived from this model: Catastrophizing, Disability, Resilience, Low Self-Efficacy, and Self-Directed Affect. Confirmatory factor analysis removed an additional seven redundant items. The five-factor model had adequate fit as the subscale and full model levels. The subscales were highly correlated with each other and had strong internal consistency. The seven-item Resilience subscale was dropped in favor of a four-factor model. The 31-item Negative Pain Cognitions Questionnaire (NPCQ) was derived from the four-factor model. The subscales of the NPCQ were sufficiently different to support a one-factor model of pain catastrophizing.