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The Fear of Pain Questionnaire-III and the Fear of Pain Questionnaire-Short Form: a confirmatory factor analysis

Authors Vambheim SM, Lyby PS, Aslaksen PM, Flaten MA, Åsli O, Martinussen LM

Received 23 January 2017

Accepted for publication 26 May 2017

Published 8 August 2017 Volume 2017:10 Pages 1871—1878

DOI https://doi.org/10.2147/JPR.S133032

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication: Dr E. Alfonso Romero-Sandoval

Sara M Vambheim,1 Peter Solvoll Lyby,1,2 Per M Aslaksen,1 Magne Arve Flaten,3 Ole Åsli,1 Laila M Martinussen4

1Department of Psychology, UiT, The Arctic University of Norway, Tromsø; 2CatoSenteret Rehabilitation Center, Son; 3Department of Psychology, NTNU, The Norwegian University of Science and Technology, Trondheim, Norway; 4Management Engineering, DTU, Technical University of Denmark, Lyngby, Denmark

Background: The Fear of Pain Questionnaire-III (FPQ-III) is a widely used instrument to assess the fear of pain (FOP) in clinical and nonclinical samples. The FPQ-III has 30 items and is divided into three subscales: Severe Pain, Minor Pain and Medical Pain. Due to findings of poor fit of the original three-factor FPQ-III model, the Fear of Pain Questionnaire-Short Form (FPQ-SF) four-factor model has been suggested as an alternative. The FPQ-SF is a revised version of the FPQ-III, reduced to 20 items and subdivided into four subscales: Severe Pain, Minor Pain, Injection Pain and Dental Pain.
Aims and methods: The purpose of the study was to investigate the model fit, reliability and validity of the FPQ-III and the FPQ-SF in a Norwegian nonclinical sample, using confirmatory factor analysis (CFA). The second aim was to explore the model fit of the two scales in male and female subgroups separately, since previous studies have uncovered differences in how well the questionnaires measure FOP across sex; thus, the questionnaires might not be sex neutral. It has been argued that the FPQ-SF model is better because of the higher fit to the data across sex. To explore model fit across sex within the questionnaires, the model fit, validity and reliability were compared across sex using CFA.
Results: The results revealed that both models’ original factor structures had poor fit. However, the FPQ-SF had a better fit overall, compared to the FPQ-III. The model fit of the two models differed across sex, with better fit for males on the FPQ-III and for females on the FPQ-SF.
Conclusion: The FPQ-SF is a better questionnaire than the FPQ-III for measurement of FOP in Norwegian samples and across sex subgroups. However, the FPQ-III is a better questionnaire for males than for females, whereas the FPQ-SF is a better questionnaire for females than for males. The findings are discussed and directions for future investigations outlined.

Keywords: fear of pain, FPQ-III, FPQ-SF, confirmatory factor analysis, pain, sex

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