Evaluating the psychometric properties of the Widespread Pain Index and the Symptom Severity Scale in youth with painful conditions

Abstract

Background: Assessing features of centralized pain may prove to be clinically meaningful in pediatric populations. However, we are currently limited by the lack of validated pediatric measures. Aim: We examined the psychometric properties of the Widespread Pain Index (WPI) and Symptom Severity (SS) scale to assess features of centralized pain in youth with painful conditions from three clinical samples: (1) musculoskeletal surgery, (2) headache, and (3) chronic pain. Methods: Participants were 240 youth aged 10 to 18 years (M age = 14.8, SD = 1.9) who completed the WPI and SS scale. Subsets of participants also completed additional measures of pain region, pain intensity, quality of life, pain interference, and physical function. Results: Increased features of centralized pain by age were seen for the WPI (r = 0.27, P < 0.01) and SS scale (r = 0.29, P < 0.01). Expected differences in sex were seen for the WPI (sex: t 132 = −3.62, P < 0.01) but not the SS scale (sex: t 223 = −1.73, P = 0.09). Reliability for the SS scale was adequate (α = 0.70). Construct validity was demonstrated through relationships between the WPI and pain regions (r = 0.57, P < 0.01) and between the SS scale and quality of life (r = −0.59, P < 0.01) and pain interference (r = 0.56, P < 0.01). Criterion validity was demonstrated by differences on the WPI between the surgery sample and the headache and chronic pain samples (F 2,237 = 17.55, P < 0.001). Comprehension of the SS scale items was problematic for some youth. Conclusions: The WPI showed adequate psychometric properties in youth; however, the SS scale may need to be modified. Our findings support the need to develop psychometrically sound instruments for comprehensive assessment of pain in pediatric samples.

Psychosocial Predictors of Acute and Chronic Pain in Adolescents Undergoing Major Musculoskeletal Surgery

“…To date, a qualitative interview study with a small subset of participants has been published from this cohort, 49 and pain and quality of life data from the baseline assessment were used in a measure validation study. 13 Results from the long-term follow up will be reported on study completion.…”

“…The WPI has shown good construct validity to assess pain distribution in youth of this age range, with both acute and chronic pain. 13 Pain catastrophizing scale-child version (PCS-C). This 13-item measure assesses extent to which youth endorse thoughts and feelings of magnification, rumination, and helplessness in response to pain.…”

Characterizing pain in long-term survivors of childhood cancer

“…On the other hand, our sample showed several similarities to chronic non-cancer pain populations, such as the relationship to pscychosocial outcomes, suggesting that models tested in chronic non-cancer pain populations may also have relevance to LTSCCs. In terms of capturing pain location, future research should inquire about all pain locations using a body map (Foxen-Craft et al, 2019) as well as consider including measures of widespread pain (Dudeney, Law, Meyyappan, Palermo, & Rabbitts, 2019). The distinction between pain phenotypes, such as those due to central sensitization, is imperative in the selection of appropriate interventions (Woolf, 2011).…”

Identification of Resting-State Network Functional Connectivity and Brain Structural Signatures in Fibromyalgia Using a Machine Learning Approach

“…To measure pain widespreadness and fibromyalgia impacts, the widespread pain index (WPI) was used to assess the pain widespreadness in FM patients by measuring painful areas in patients [ 17 ]. Recent evidence shows that WPI has an acceptable construct validity and reliability in chronic pain youth patients [ 26 ].…”