Validation of the German fear of pain questionnaire in a sample of children with mixed chronic pain conditions

Eur J Pain. 2017 Aug;21(7):1224-1233. doi: 10.1002/ejp.1022. Epub 2017 Apr 2.

Abstract

Background: To date, no German instrument exists to measure pain-related fear in paediatric pain populations. The objective of the current study was to determine the construct validity of the translated German fear of pain questionnaire for children (GFOPQ-C) in a sample of children with mixed chronic pain disorders by testing the underlying factor structure, and its psychometric properties.

Method: N = 241 children with mixed chronic pain disorders (aged 8-19 years) presenting to a specialized pain clinic completed the GFOPQ-C and several other pain, fear and disability measures.

Results: The two-factor structure of the FOPQ-C (fear, avoidance) was replicated. Internal consistency for the shortened German version was good for both subscales (Fear subscale: α = 0.89; avoidance subscale: α = 0.76). As expected, the fear subscale correlated highly with anxiety sensitivity (r = 0.63), pain catastrophizing (r = 0.62) and general anxiety (r = 0.54), while the avoidance subscale was more closely related to disability (r = 0.24) and school functioning (r = 0.28). Pain-related fear differed in children with chronic pain depending on their pain location with higher fear ratings in children with abdominal pain and musculoskeletal pain.

Conclusion: The GFOPQ-C is a valid instrument that assesses two distinct dimensions of pain-related fear in children: fear and avoidance. Future research is needed to evaluate the impact of increased pain-related fear on outcomes over time as well as to examine pain-related fear among healthy children. This will enhance our knowledge of who might be particularly vulnerable to potentially dysfunctional trajectories, such as ongoing pain or anxiety symptoms.

Significance: The current study validates the first tool to assess pain-related fear in German-speaking children with chronic pain. Findings support two distinct domains: fear and activity avoidance.

MeSH terms

  • Adolescent
  • Anxiety / psychology*
  • Child
  • Chronic Disease / psychology*
  • Chronic Pain / physiopathology*
  • Chronic Pain / psychology
  • Disabled Persons
  • Fear / psychology*
  • Humans
  • Musculoskeletal Pain / physiopathology*
  • Pain Clinics
  • Pain Measurement / methods
  • Phobic Disorders / psychology*
  • Psychometrics
  • Reproducibility of Results
  • Somatoform Disorders / physiopathology*
  • Surveys and Questionnaires

Supplementary concepts

  • Phobia, Specific