State versus Trait: Validating State Assessment of Child and Parental Catastrophic Thinking about Child Pain

Abstract

Pain catastrophizing has emerged as one of the most robust predictors of child pain outcomes. Although assessments of state (i.e., situation-specific) pain catastrophizing in children and parents are often used, their psychometric properties are unknown. This study aimed to assess factor structure, reliability and predictive validity of state versions of Pain Catastrophizing Scales for children (PCS-C State) and parents (PCS-P State) relative to corresponding trait versions for child and parental pain-related outcomes. Data were pooled from 8 experimental pain studies wherein child and/or parent state catastrophizing (measured immediately before application of a pain stimulus) and trait catastrophizing were assessed in community-based samples of children aged 8–18 years (N=689) and their parents (N=888) in Dutch or English. Exploratory factor analyses were conducted to examine the underlying factor structure of the PCS-P/PCS-C State, revealing a single factor solution that explained 55.53% of the variance for children and 49.72% for parents. Hierarchical linear regression analyses were used to examine relative influence of state versus trait catastrophizing on child and parent pain-related outcomes. Child and parent state catastrophizing were significantly associated with child pain intensity, child state anxiety and parental distress. State catastrophizing scores showed stronger associations than trait scores for most outcomes.