What do chronic pain patients think of their pain? Towards a pain cognition questionnaire

The three-systems model of chronic pain emphasizes the partially independent relationship among physiological, gross motor and verbal-cognitive responses of chronic pain patients. This study describes the development of an assessment instrument representing a measure for the verbal-cognitive response system of chronic pain. Fifty items, each of which is assigned to one of five factors (pain impact, catastrophizing, outcome efficacy, acquiescence and reliance on health care) constitute the new Pain Cognition List (PCL). The PCL was developed using a Dutch back pain population and proves to be stable across sex and back pain diagnosis. By means of three experiments the PCL is shown to be reliable and sufficiently valid. The PCL might be a promising tool for identifying pain patients whose pain problem is mainly controlled by cognitive factors.