Fear of Pain Questionnaire‐9: Brief assessment of pain‐related fear and anxiety

Abstract

Background Fear and anxiety are important considerations in both acute and chronic pain. Effectively and efficiently measuring fear and anxiety associated with pain in healthcare settings is critical for identifying vulnerable patients. The length and administration time of current measures of pain‐related fear and anxiety inhibit their routine use, as screening tools and otherwise, suggesting the need for a shorter, more efficient instrument. Methods A 9‐item shortened version of the Fear of Pain Questionnaire – III ( FPQ ‐ III ), the Fear of Pain Questionnaire‐9 ( FPQ ‐9), was developed based upon statistical analyses of archival data from 275 outpatients with chronic pain and 275 undergraduates. Additionally, new data were collected from 100 outpatients with chronic pain and 190 undergraduates to directly compare the standard and short forms. Exploratory and confirmatory factor analyses, and other psychometric analyses, were conducted to examine and establish the FPQ ‐9 as a reliable and valid instrument. Results The original three‐factor structure of the FPQ ‐ III was retained in the shortened version; a confirmatory factor analysis produced good model fit ( RMSEA = 0.00, CFI = 1.00, TLI = 1.00, SRMR = 0.03). Results suggested a high degree of correlation between the original FPQ ‐ III and the new FPQ ‐9 ( r = 0.77, p < 0.001). Measures of internal consistency for FPQ ‐9 subscales were high; correlations with other pain and anxiety instruments suggested concurrent, convergent and divergent validity. Conclusions The FPQ ‐9 is a psychometrically sound alternative to longer instruments assessing fear and anxiety associated with pain, for use in both clinical and research situations that only allow brief screening. Significance The FPQ ‐9 has considerable potential for dissemination and utility for routine, brief screening, given its length (completion time ~2 min; scoring time ~1 min), reading level and psychometric properties.

Transmission of dental fear from parent to adolescent in an Appalachian sample in the USA

“…There are three factorially derived subscales: (a) Fear of Dental/Medical Pain, (b) Fear of Severe Pain, and (c) Fear of Minor Pain; a total score also can be derived. There is support for the validity of the FPQ‐9; it has been tested psychometrically and has been found to have good internal consistency and test‐retest reliability …”

“…General fearfulness about pain was assessed with the Fear of Pain Questionnaire‐9 (FPQ‐9). The FPQ‐9, a shortened version of the reliable and valid Fear of Pain Questionnaire‐III, assesses fear about pain across a variety of events, and is suitable for use in both adult and adolescent populations.…”

The Fear of Pain Questionnaire: Factor structure, validity and reliability of the Italian translation

“…the suggested three-factor structure, divergent validity with respect to pain intensity, depression and anxiety scores, and test-retest reliability) in a heterogeneous sample of Italian individuals. To better comprehend the FPQ-III’s factorial structure, a CFA was also performed for each of the two reduced versions of the FPQ-III, namely the FPQ-Short Form (FPQ-SF) [16] and the FPQ-9 [17]. We did not consider item-parcel versions of the FPQ-III because item parcelling could lead to distortion of the factor structure [18].…”

Assessment of pain-related fear in individuals with chronic painful conditions

“…The FPQ-III has high test–retest reliability ( r =0.92) and internal consistency (α=0.74), which has been confirmed by other studies. 23 – 28 …”

“…The validity and reliability of the FPQ-III have been assessed in healthy participants, college students, dental patients, and chronic pain patients with major psychiatric diagnosis. 20 , 23 – 28 However, its applicability in identifying individuals likely to experience longer duration and greater frequency of pain from a community-based sample has not previously been examined. Therefore, this study aimed to examine the association between subscales of the FPQ-III and duration and frequency of pain in individuals from a community-based sample.…”