Development and preliminary evaluation of a short self-report measure of generalized pain hypersensitivity
Received 1 August 2018
Accepted for publication 8 December 2018
Published 17 January 2019 Volume 2019:12 Pages 395—404
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Dr E Alfonso Romero-Sandoval
Peter F van Bemmel,1 Martijn AH Oude Voshaar,2 Peter M ten Klooster,2 Harald E Vonkeman,1,2 Mart AFJ van de Laar1,2
1Department of Rheumatology, Medisch Spectrum Twente, Enschede, Netherlands; 2Department of Psychology, Health, and Technology, University of Twente, Enschede, Netherlands
Purpose: Generalized pain hypersensitivity is frequently observed in chronic pain conditions. Currently, identification is based on expert clinical opinion, and in very few cases combined with quantitative sensory testing. The objectives of this study were to develop and evaluate a short self-report measure of generalized pain hypersensitivity: a generalized pain questionnaire (GPQ).
Methods: Items for the GPQ were developed based on a literature review, followed by an interview study with ten rheumatic patients with suspected pain hypersensitivity. We examined the psychometric properties of the preliminary items in a sample of 212 outpatients suffering from either fibromyalgia (FM; n=98) or rheumatoid arthritis (n=114). Additionally, self-reported data were gathered on sociodemographics, fibromyalgia-survey criteria, health status, and neuropathic-like pain features.
Results: Mokken-scale analyses demonstrated a unidimensional seven-item scale with strong homogeneity (H=0.65) and high reliability (ρ=0.90). Correlations between total GPQ scores and relevant external measures, such as the FM-survey criteria and neuropathic-like pain features, were consistent with a priori expectations, supporting its external construct validity. Furthermore, the GPQ had good accuracy in distinguishing between patients with FM (generally assumed to be the result of central nervous system hypersensitization) and patients with RA (assumed to result mostly in local nociceptive or inflammatory pain), with an area under the receiver-operating characteristic curve of 0.89. A cutoff value >10 had the highest combination of sensitivity (82.7%) and specificity (77.2%).
Conclusion: The GPQ is psychometrically sound and appears promising for measuring the presence and severity of generalized pain hypersensitivity in chronic pain patients.
Keywords: central sensitization, chronic pain, nociceptive pain, questionnaires
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