Abstract
Recently, the lexicon of pain was refined into a parsimonious set of words making
up the Pain Descriptor System (PDS). The present study investigated the latent structure
of the sensory category of the PDS with its 24 descriptors distributed equally across
8 subcategories. A sample of 629 chronic pain patients rated the degree to which each
of these words described their pain. It was found that coldness-related words were
rarely used and shared high covariance with other descriptors, thus warranting their
removal as a subcategory. Confirmatory factor analysis of a previously theorized single
higher-order model of 7 latent factors (each with 3 observed variables) resulted in
poor fit, x2(181) = 377.72, P < .05; comparative fit index (CFI) = .915; root mean square error of approximation
(RMSEA) = .04. This model was replaced with a dual higher-order model retaining the
same 7 latent factors plus 2 higher-order factors corresponding to deep pain versus
superficial pain. This model provided a good representation of the data, x2(181) = 301.07, P < .05; CFI = .948; RMSEA = .032. Therefore, descriptors of pain sensation differentiate
sensory quality while also reflecting a fundamental dichotomy supported by neurophysiological
research. Thus, the lexicon can illuminate pathophysiology, thereby clarifying pain
diagnoses.
Perspective
Confirmatory factor analysis was performed on pain sensation descriptors used by 629
patients. This supported a hierarchical model with 7 lower-order factors plus 2 higher-order
factors corresponding to deep pain versus superficial pain. By reflecting neurophysiology,
this lexicon of pain can offer diagnostic clues.
Key words
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References
- Acute low back pain: Diagnostics and treatment.Clin Excell Nurse. 2001; 5: 80-84
- Pain assessment at nurse triage: A literature review.Emerg Nurse. 2006; 14: 26-29
- The Language of Pain: Finding Words, Compassion, and Relief.W.W. Norton & Company, London, UK2010
- Confirmatory Factor Analysis for Applied Research.Guilford Press, New York, NY2006
Cervero F: The gate theory, then and now, in Villanueva L, Dickenson A, Ollat H (eds): The Pain System on Normal and Pathological States: A Primer for Clinicians. Prog Pain Res Manag 31:33-48, 2005
Chapman CR, Okifuji A: Pain: Basic mechanisms and conscious experience, in Dworkin RH, Breitbart WS (eds): Psychosocial Aspects of Pain: A Handbook for Healthcare Providers. Prog Pain Res Manag 27:3-27, 2004
- Selective attention to pain-related information in chronic musculoskeletal pain patients.Pain. 2003; 105: 37-46
- Pain and the defense response: Structural equation modeling reveals a coordinated psychophysiological response to increasing painful stimulation.Pain. 2003; 102: 97-108
Fernandez E: The Pain Descriptor System: A cumulative refinement of the vocabulary for pain assessment. Presented at the 27th Annual Scientific Meeting of the American Pain Society, Tampa, FL, 2008
- A parsimonious set of verbal descriptors of pain sensation derived from the McGill Pain Questionnaire.Pain. 1996; 66: 31-37
- Parsimonious collection of pain descriptors: Classification and calibration by pain patients.J Pain. 2011; 12: 440-450
- Studies in Neurology.Oxford University Press, London, UK1920
- Distinct forebrain activity patterns during deep versus superficial pain.Pain. 2006; 120: 286-296
- Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives.Struct Equ Modeling. 1999; 6: 1-55
- Pain.McMillan, London, UK1942
- Frequency of chronic pain descriptors: Implications for assessment of pain quality.Eur J Pain. 2011; 15: 628-633
- The McGill Pain Questionnaire: Major properties and scoring method.Pain. 1975; 1: 277-299
- Mplus User’s Guide.Muthén & Muthén, Los Angeles, CA2010
- Differential activation of the human trigeminal nuclear complex by noxious and non-noxious orofacial stimulation.Hum Brain Mapp. 2009; 30: 3772-3782
- Psychological Mechanisms of Pain and Analgesia.IASP Press, Seattle, WA1999
- A literature review into pain assessment at triage in accident and emergency departments.Accid Emerg Nurs. 2003; 11: 12-17
- Reclassification and rescaling of MPQ verbal descriptors of pain sensation: A replication.Clin J Pain. 1996; 12: 270-276
Article info
Publication history
Published online: April 27, 2012
Accepted:
February 17,
2012
Received in revised form:
February 4,
2012
Received:
August 15,
2011
Footnotes
Funded by grant R21NR009665 from the National Institutes of Health awarded to the first author.
There is no conflict of interest in the conduct of this research or its representation herein.
Identification
Copyright
© 2012 American Pain Society. Published by Elsevier Inc. All rights reserved.
