Dimensional and componential structure of a hierarchical organization of pain-related anxiety constructs

Research has identified several anxiety and fear constructs that contribute directly or indirectly to the chronic course of pain. One way to gain insight into the frequently observed interrelations between these constructs may be by conceptualizing them within a hierarchical structure. In this structure, general and specific constructs are proposed at different levels of a hierarchical tree. The present study sought to find evidence for this idea by exploring the dimensional and componential structure of a hierarchical representation of pain-related anxiety constructs. Small cards describing the individual items of 9 pain-related anxiety measures were presented to undergraduate students (N = 294), who were asked to sort them into piles of what they perceived as items of similar meaning. Cluster analysis (additive tree analyses) revealed cluster groups that could be interpreted along the lines of the proposed hierarchical structure. Multidimensional scaling analysis showed that the similarity data are characterized by a dimension that runs from general affective to pain-specific concerns. This study thus offers empirical support for the postulation of a general and specific hierarchical ordering of these constructs. Furthermore, its results endorse the independent use of various pain-related anxiety measures in research and practice aiming to assess negative emotional constructs that contribute to pain.