Cross‐cultural Adaptation and Psychometric Properties of the Greek Version of the Central Sensitization Inventory

Abstract

Objectives Recent studies support the opinion that central sensitization (CS) plays an important role in the pathophysiology of many chronic pain conditions. CS refers to hyperexcitability of the central nervous system, which can result in pain hypersensitivity and other somatosensory symptoms. Recognition of CS‐related symptomology is crucial in chronic pain evaluation and rehabilitation. The Central Sensitization Inventory (CSI) was created to evaluate symptoms that have been found to be associated with CS. The aim of the current study was the cross‐cultural adaptation of the CSI into Greek (CSI‐Gr). Methods To evaluate discriminate validity, 200 patients with chronic pain and 50 healthy control subjects participated. The sample was divided into 4 diagnostic groups (fibromyalgia, single pain complaints, multiple pain complaints, and a control group) and into 5 CSI severity subgroups, from subclinical to extreme. Convergent validity was determined by evaluation of the relationship between the CSI‐Gr and the Pain Catastrophizing Scale (PCS). Additionally, 30 patients completed the CSI a second time for the purpose of a test/retest analysis. Results The results showed high internal consistency (Cronbach's alpha = 0.994) and test‐retest reliability (intraclass correlation coefficient = 0.993). The standard error of measurement was 2.1. The CSI‐Gr correlated moderately with the PCS (r = 0.68). Statistically significant differences were found among the 3 comparison groups, with patients who had fibromyalgia reporting the highest CSI severity and healthy control subjects reporting the lowest severity. Conclusions As determined in the present study, the CSI‐Gr was found to be a reliable and valid tool for recognition of CS‐related symptomology.

Convergent and Discriminant Validity of the Serbian Version of the Central Sensitization Inventory

“…Support for the discriminant validity of the Serbian version of the CSI was provided by confirming the ability of total scores to discriminate among various types of chronically painful conditions and healthy controls, with presumably different levels of CS. Support for convergent validity of the CSI was provided by associations between CSI total scores, severity levels, and other CS‐related patient‐reported symptoms, including pain severity, sleep disturbance, cognitive functioning, pain catastrophizing, pain‐related fear‐avoidance beliefs, perceived level of disability, and perceived general mental and physical health, as has been found in previous studies 5–7 . The results of the present study provide additional support for the potential usefulness of the CSI in chronic pain assessment and treatment planning.…”

“…The CSI has been psychometrically evaluated in English and other Asian, South American, and European languages. It has been found to be psychometrically sound in all published cross‐cultural studies to the present, with test‐retest reliability coefficients from 0.85 to 0.99 and Cronbach’s alpha from 0.88 to 0.99 5–7 . Evidence of convergent, discriminant, and predictive validity, using both subjective (eg, patient‐reported) and objective (including quantitative sensory testing, brain gamma aminobutyric acid levels, serum brain‐derived neurotrophic factor) CS‐related variables, have been found in a number of previous studies using multiple‐language versions of the CSI 5,8 .…”

“…Differences in CSI scores have been found among patient groups and healthy controls, as well as among patient subgroups (including those with acute pain, chronic pain, and specific disorders such as fibromyalgia) 5 . The questionnaire has demonstrated favorable psychometric properties across cultures 5–8 . Multiple‐language versions are available at http://www.pridedallas.com/questionnaires.…”

Cross-cultural adaptation and validation of the Finnish version of the central sensitization inventory and its relationship with dizziness and postural control

“…Previous studies have shown good discriminative ability of the CSI to distinguish between chronic pain subjects and control subjects without pain [32][33][34]. Associations have been found between CSI scores and other validated patient-reported measures of CS-related symptoms, including depression symptoms, kinesiophobia, perceived disability, health-related quality of life, and sleep problems [26,27,30,33] Due to rationale linking chronic pain syndromes and fibromyalgia with postural control instability, it was hypothesized that there may be a potential relationship between higher CSI scores and postural control instability on a force plate. The force plate is mechanical sensing systems designed to measure the ground reaction forces and moments involved in postural control [36].…”

“…The CSI is considered the leading patient-reported outcome measure (PROM) for assessing CS-related symptomology [19]. Although it has a short, less than ten year history, the CSI has been translated and validated in adult populations into many languages, including Dutch [20], Spanish [21], Brazilian Portuguese [22], Gurajati [23], Serbian [24], French [25], Japanese [26], Greek [27], Nepalese [28], Russian [29], and Italian [30]. Additionally, the CSI has been validated in an adolescent population in European Portuguese [31].…”