Development of the Pain Appraisal Inventory: Psychometric properties

Abstract

OBJECTIVE: To discuss the development, content validity, internal consistency and factor structure of a Pain Appraisal Inventory (PAI). DESIGN: A PAI was constructed with a threat appraisal scale and a challenge appraisal scale. Content validity was demonstrated with apanel of health experts. A sample of 309 individuals participated in a random community survey about troublesome pain in the two weeks preceding the telephone interview. RESULTS: Confirmatory factor analysis produced a two-factor structure comprising threat appraisal and challenge appraisal. Cronbach's alphas were 0.86 for the threat scale and 0.81 for the challenge scale. Threat appraisal was correlated with respondents' scores on the McGill Pain Questionnaire, the Pain Disability Index, and measures of pain intensity and emotional upset due to pain. Challenge appraisal was reported by only 14% of the sample and limited the usefulness of statistical analyses for this variable. CONCLUSIONS: Appraisal of pain may be key to the underlying overall adjustment of an individual to pain. The PAI distinguishes between threat and challenge appraisal of pain, and may have considerable utility for the measurement of appraisal in experimental, epidemiological and clinical pain research.