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Objectives: The primary aim of this study was to better understand the role that social factors (ie, social support, satisfaction in participation with social roles, social isolation, and self-perceived ability to perform social roles and activities) play in pain-related interference and depressive symptoms in adults with chronic pain. Moreover, this study also examined if sex exerts a moderating role in these associations., Materials and Methods: In this cross-sectional study, 364 adults with chronic pain participated: 133 were university students and 231 were individuals from the community. University students completed a paper-and-pencil survey and individuals from the community responded to a web-based survey. Both surveys included the same questions assessing sociodemographic, pain characteristics, pain-related interference, depressive symptoms, and social factors., Results: Only satisfaction in participation in usual social roles and self-perceived ability for participating in such social roles contributed independently, significantly, and negatively to the prediction of pain interference, whereas all 4 social factors made independent and significant contributions to the prediction of depressive symptoms. Satisfaction with participation in usual social roles, self-perceived social ability, and social support were negatively related to depressive symptoms, whereas social isolation was positively related. The results also indicated that sex moderated the associations between social factors and depressive symptoms, but not between social factors and pain interference., Discussion: The study provides important new findings regarding the associations between social factors and physical and psychological functioning of individuals with chronic pain, supporting biopsychosocial models.

Objectives: To clarify the importance of avoidance, pacing, and overdoing pain-related activity management patterns as predictors of adjustment in patients with fibromyalgia syndrome., Methods: A total of 119 tertiary care patients with fibromyalgia syndrome who agreed to be part of an activity management pain program completed a survey, which requested information about demographics, pain intensity and pain interference, psychological and physical function, and pain-related activity management patterns. Hierarchical regression analyses were used to identify the unique contributions of the 3 different pain-related activity management patterns (avoidance, pacing, and overdoing) to the prediction of pain interference, psychological function, and physical function., Results: The avoidance pattern was a significant and unique predictor of worse psychological and physical function as well as greater pain interference. Pacing was significantly associated with less pain interference and better psychological function, whereas overdoing was not found to predict patient functioning., Discussion: The findings confirm the importance of pain-related activity management patterns as predictors of patient function, and support the necessity of addressing these factors in chronic pain treatment. In addition, the results suggest that targeting increases in activity pacing and decreases in pain avoidance, specifically, might yield the best patient outcomes. However, further research to evaluate this possibility is necessary.

Reliable and valid measures of pain intensity are needed to accurately evaluate the efficacy of pain treatments. Perhaps with the exception of faces pain intensity scales, which are thought to reflect both pain intensity and pain affect, the other most commonly used pain intensity scales-Numerical Rating Scales (NRSs), Visual Analog Scales, and Verbal Rating Scales (VRSs)-are all thought to reflect primarily pain intensity or the magnitude of felt pain. However, to our knowledge, this assumption has not been directly tested for VRSs., Methods: We evaluated whether VRS pain severity ratings are influenced by pain beliefs, catastrophizing, or pain interference over and above any effects of pain intensity, as measured by a NRS, in 4 samples of individuals with physical disabilities and chronic pain., Results: As hypothesized, and while controlling for pain intensity as measured by a NRS, higher scores on factors representing pain interference with function, pain catastrophizing, and a number of pain-related beliefs were all associated with a tendency for the study participants to rate their pain as more severe on a VRS., Discussion: These findings indicate VRSs of pain severity cannot necessarily be assumed to measure only pain intensity; they may also reflect patient perceptions about pain interference and beliefs about their pain. Clinicians and researchers should take these findings into account when selecting measures and when interpreting the results of studies using VRSs as outcome measures.

Objectives: Emotional responses to pain are known to play an important role in the development and maintenance of pain. To better understand the role that pain anxiety plays in chronic pain, as well as to evaluate treatments that might treat it effectively, reliable and valid measures of pain anxiety are needed. Thus, the aim of this study was to provide additional evidence regarding the psychometric properties of the Child Pain Anxiety Symptoms Scale (CPASS) in a sample of adolescents., Methods: A total of 357 adolescents ages 12 to 19 years completed measures of pain anxiety (CPASS), pain-related catastrophizing (PCS-C), anxiety sensitivity (CASI), and sleep quality (NRS-Sleep). We used confirmatory factor analyses to evaluate the factor structure of CPASS items. We also tested the reliability and the validity of CPASS scores., Results: Confirmatory factor analyses suggested a 4-factor structure with a single higher-order factor (CFI=0.91, TLI=0.95, RMSEA=0.078). The total score of CPASS showed good internal consistency (α=0.87) and adequate validity as evidenced by (1) moderate to high correlations between CPASS-PCS-C (r=0.74, P<0.001) and CPASS-CASI (r=0.48, P<0.001) and (2) the magnitude of the correlations between CPASS-PCS-C and CPASS-CASI being significantly greater than that between CPASS and NRS-Sleep (z=14.70 and 8.96, respectively; P<0.001)., Discussion: The findings support the reliability and the validity of CPASS as a measure of pain-related anxiety in adolescents.