Related Experiment Video
Updated: Nov 25, 2025
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
Development of a Short Form of the Negative Pain Thoughts Questionnaire (NPTQ)
Anne-Britt Dekker1, Teun Teunis2, Inger Schipper3
1Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, Austin, Texas.
Background:
Thoughts affect pain intensity and the magnitude of activity intolerance for a given nociception. The Negative Pain Thoughts Questionnaire (NPTQ) measures common unhelpful cognitive biases regarding pain. A shorter version of the NPTQ could be used in daily practice to improve health by identifying important misconceptions.
Methods:
One hundred and thirty-seven patients seeking specialty musculoskeletal care completed questionnaires addressing demographics, negative pain thoughts, worst-case thinking, resiliency, the magnitude of self-reported activity intolerance, and pain intensity. Patients were randomly allocated to a learning cohort (110 patients, 80%) and a validation cohort (27 patients, 20%). Based on factor analysis of the learning cohort, 4 questions were selected to create the NPTQ short form (NPTQ-SF). Floor and ceiling effects of the NPTQ and NPTQ-SF were analyzed. Psychometric properties of the NPTQ-SF were tested with use of Spearman correlations with the NPTQ. The internal consistency of the NPTQ and NPTQ-SF was analyzed with use of the Cronbach α coefficient. To test external validity, we calculated Spearman correlations with pain intensity, activity intolerance, the Pain Catastrophizing Scale, and the Brief Resiliency Scale in the validation cohort.
Results:
The Cronbach α was 0.90 for the NPTQ and 0.85 for the NPTQ-SF. The Spearman correlation between NPTQ and NPTQ-SF scores was 0.91 in the learning cohort and 0.93 in the validation cohort. In the validation cohort, there was no difference in the strength of the correlations of the NPTQ and NPTQ-SF with other questionnaires.
Conclusions:
These findings support the use of a brief, 4-question measure of unhelpful cognitive biases regarding pain in both research and patient care. The NPTQ-SF would benefit from external validation in an independent cohort.
Clinical Relevance:
The notable influence of common misconceptions (i.e., cognitive bias) on musculoskeletal symptoms can be measured with a brief questionnaire and used as a point of discussion with patients.
More Related Videos
Related Concept Videos
01:30Negative and Cognitive Symptoms of Schizophrenia
Negative Symptoms
Negative symptoms of schizophrenia manifest as deficits in normal emotional and behavioral functioning, profoundly impacting daily life. Individuals with schizophrenia often display a flat affect, characterized by a near-total absence of emotional expression,...
01:22Self-Report Tests of Personality