Last updated: Sat, Aug 24, 2024
Pain researchers have available a vast armamentarium of what are called psychosocial measures, some of which are specific to pain. Psychosocial seems to mean either psychological or social. These measures are the result of the scoring of questionnaires, which are also called instruments.
Psychosocial measures used in pain research include:
The better of these instruments are carefully designed, tested, and validated, similar to the validation of the McGill Pain Questionnaire described earlier (The McGill Pain Questionnaire). Normative data, that is, normal values, are available for some of the instruments and some populations.
To give you an idea of the use of instruments in pain research, I'll briefly describe some of the instruments in the last category above: instruments closely tied to the CBT perspective.
The Pain Beliefs and Perceptions Inventory dates to about 1989. It contains sixteen questions, and yields scores in three areas: 1) self-blame for pain; 2) belief that pain is mysterious (that there is no explanation for it); 3) belief that pain is permanent. Those with higher pain intensity are more likely to believe that pain is permanent and that it is likely to persist despite treatment. Such patients are more likely to not be compliant in following conservative treatment recommendations. Those who believe that pain is permanent and its source is a mystery are likely to have negative self-perceptions.1
The Cognitive Risk Profile for Pain was developed about 2006, and evaluates several areas of beliefs about pain and pain treatment that the developers saw as possible roadblocks to successful pain management. The instrument provides scores reflecting philosophic beliefs about pain; beliefs about the relation between pain and mood; perceptions of “blame” about pain; adequacy of support; entitlement to disability; desire for a medical breakthrough (which would resolve the pain problem); skepticism about the multi-disciplinary treatment of pain; convictions of hopelessness. Since this instrument is intended to identify factors that put patients at risk of poor outcome in standard pain management, and since these factors are considered to be well-known, the instrument is thought to have high face validity in the eyes of the community of therapists and researchers who believe in the validity of these factors.2
The Multidimensional Pain Readiness to Change Questionnaire is another recent instrument (ca. 2003), and contains 46 items that are intended to evaluate the subject's readiness to adopt coping strategies that are believed effective by those who teach pain management. The instrument yields nine scales related to: 1) exercise; 2) task persistence; 3) relaxation; 4) cognitive control; 5) pacing; 6) avoiding “contingent rest”; 7) avoiding asking for help; 8) assertive communication; 9) proper body mechanics.3
The Coping Strategies Questionnaire (ca. 1983) is intended to measure the subject's use of a number of “coping strategies” that are believed to be important by those who teach pain management to pain sufferers. The instrument provides scores for a number of coping strategies: 1) diverting attention; 2) reinterpreting pain sensations; 3) coping self-statements; 4) ignoring pain sensations; 5) praying or hoping; 6) catastrophizing; 7) increasing activity. In addition to these “primary” scales, “composite” scales (which combine categories) have been developed: coping attempts; pain control and rational thinking; active coping; coping flexibility. These categories (both primary and composite) are all based on the cognitive-behavioral theory of pain management. None of the seven primary coping categories has been strongly supported by effectiveness research.4
All of these instruments are closely coupled to the cognitive-behavioral model of pain and pain treatment. They assume the validity of that model and, in effect, serve as operational definitions of the concepts related to that model. Because they are embedded in that model, they are best seen as aids to refining treatments that are based on that model, rather than as sources of information that can either confirm or disconfirm the cognitive-behavioral model itself. Behaviorist Theories of Pain and a Standard Model discusses the cognitive-behavioral model of pain, treatments based on the model, and the strength of scientific support for that model.