Assessing Pain Anxiety in Adolescents: Further Evidence for the Utility of the Child Pain Anxiety Symptoms Scale.

Emotional responses to pain are known to play an important role in the development and maintenance of pain. To better understand the role that pain anxiety plays in chronic pain, as well as to evaluate treatments that might treat it effectively, reliable and valid measures of pain anxiety are needed. Thus, the aim of this study was to provide additional evidence regarding the psychometric properties of the Child Pain Anxiety Symptoms Scale (CPASS) in a sample of adolescents.A total of 357 adolescents ages 12 to 19 years completed measures of pain anxiety (CPASS), pain-related catastrophizing (PCS-C), anxiety sensitivity (CASI), and sleep quality (NRS-Sleep). We used confirmatory factor analyses to evaluate the factor structure of CPASS items. We also tested the reliability and the validity of CPASS scores.Confirmatory factor analyses suggested a 4-factor structure with a single higher-order factor (CFI=0.91, TLI=0.95, RMSEA=0.078). The total score of CPASS showed good internal consistency (α=0.87) and adequate validity as evidenced by (1) moderate to high correlations between CPASS-PCS-C (r=0.74, P<0.001) and CPASS-CASI (r=0.48, P<0.001) and (2) the magnitude of the correlations between CPASS-PCS-C and CPASS-CASI being significantly greater than that between CPASS and NRS-Sleep (z=14.70 and 8.96, respectively; P<0.001).The findings support the reliability and the validity of CPASS as a measure of pain-related anxiety in adolescents.