Validity and reliability of the perseverative thinking questionnaire in patients with fibromyalgia

Patients with fibromyalgia often experience repetitive negative thinking, which contributes to psychological distress. The Perseverative Thinking Questionnaire (PTQ) is a tool designed to assess this cognitive pattern. However, its psychometric properties have not been tested in fibromyalgia.

This study aimed to assess the validity and reliability of the PTQ in patients with fibromyalgia.

A cross-sectional study was conducted in patients meeting the 2016 revisions to the 2010/2011 fibromyalgia diagnostic criteria. Participants were asked to complete the PTQ, Revised Fibromyalgia Impact Questionnaire (FIQR), Hospital Anxiety and Depression Scale (HADS), long version of the Ruminative Response Scale (RRS), and Short Form-12 (SF-12). Test-retest reliability was assessed over a 15-day interval. Internal consistency was evaluated using Cronbach's alpha, and construct validity was examined via Spearman's correlation analyses.

The study included 57 patients (55 female, 2 male) with a mean age of 45.1 ± 10.0 years. The PTQ demonstrated excellent internal consistency (Cronbach's alpha = 0.996) and test-retest reliability (intraclass correlation coefficient (ICC) = 0.992, 95% CI = 0.986 to 0.996, p < 0.001). Correlation analyses revealed that PTQ scores were strongly correlated with the RRS, HADS total, HADS-anxiety, HADS-depression, and SF-12 mental component scores, and moderately correlated with SF-12 physical component scores. Higher levels of perseverative thinking were associated with poorer physical, psychological, and mental health outcomes. However, a ceiling effect was detected, suggesting limited discrimination at the higher score range.

The PTQ is a reliable and valid tool for assessing perseverative thinking in patients with fibromyalgia. The strong psychometric properties support its use in clinical and research settings. However, ceiling effects should be considered when interpreting scores. Key Points • The PTQ demonstrated excellent internal consistency and test-retest reliability in patients with fibromyalgia. • The PTQ demonstrated moderate-strong correlations with rumination, anxiety, depression, and quality of life. • The PTQ is a reliable and valid tool for assessing perseverative thinking in patients with fibromyalgia.