Fear and pain observation questionnaire: Method for measuring the initial phase of psychological changes assocaited with chronic pain
Abstract
Acute pain and the cognitive processing of pain trigger fear and focus attention on pain. Adjustment or maladjustment of patients to chronic pain depend on these processes.
In this work, we outline statistically verified models of psychological changes associated with chronic pain: a model of consecutive stages, a model of the feedback effect of fear and pain observation on the subsequent increase of pain and patient (mal)adjustment, and a model unifying both previous models- great fear and the focusing of attention on pain gradually induce: a) Withdrawal and resignation, changes of mood (anxiety, anger, depression), changes of self-perception, of behavior, of social communication, and finally, changes of the original opinion relating to pain. b) Reinforcement of pain by fear and the focus of attention. The Fear and Observation of Pain Questionnaire (FOPQ) has two scales, Fear of Pain (7 items, Alfa = 0.89) and Observation of Pain (4 items, Alfa = 0.78), r = 0.14.
The questionnaire was standardized using a sample of 174 patients with non-malignant chronic pain, age 48.70 (SD = 10.72, pain duration 11.27 (9.77). Concurrent validity testing showed significant correlation of both scales with tests of the cognitive processing of pain, anxiety, anger and depression, changes of behavior and social communication.
Fear of Pain correlates with the tests of these processes more closely than does Observation of Pain. The article includes a flow chart of the processes of psychological changes associated with chronic pain, mediated by Fear of Pain and Observation of Pain, and supported by multivariate methods.
The Fear and Observation of Pain Questionnaire should find application in both clinical practice and research into the psychology of chronic pain.