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Pain Catastrophizing Scale

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The Pain Catastrophizing Scale (PCS), developed by Dr. Michael Sullivan in 1995, is a tool designed to assess the extent to which an individual catastrophizes their experience with pain. Catastrophizing is characterized by an exaggerated negative mental state that can worsen the perception and impact of pain. The PCS is intended for use in adults between the ages of 18 and 64. The purpose of the scale is to measure the level of pain-related catastrophizing related to a chronic pain condition, medical procedure, illness, or injury.

Subsets

The PCS involves three subsets related to catastrophizing: rumination, helplessness, and magnification.

  • Rumination (PCS-R)
    Involves persistent thoughts about pain (statements 8, 9, 10, 11)
  • Helplessness (PCS-H)
    Involves feelings of inability to cope with pain (statements 6, 7, 13)
  • Magnification (PCS-M)
    Involves Inflation of the threat or seriousness of pain (statements 1, 2, 3. 4, 5, 12)

Statements

The statements are as follows:

  1. I worry all the time about whether the pain will end.
  2. I feel like I can't go on.
  3. It’s terrible, and I think it’s never going to get any better.
  4. It’s awful, and I feel that it overwhelms me.
  5. I feel I can’t stand it anymore.
  6. I become afraid that the pain will get worse.
  7. I keep thinking of other painful events.
  8. I anxiously want the pain to go away.
  9. I can’t seem to keep it out of my mind.
  10. I keep thinking about how much it hurts.
  11. I keep thinking about how badly I want the pain to stop.
  12. There’s nothing I can do to reduce the intensity of the pain.
  13. I wonder whether something serious may happen.

Ratings

Each statement is rated on a scale from 0 to 4 as follows:

  • Not at all (0)
  • To a slight degree (1)
  • To a moderate degree (2)
  • To a great degree (3)
  • All the time (4)

Scores

The maximum total score possible is 52 (four points for each of the 13 statements). A total score above 30 suggests a clinically significant level of pain catastrophizing. The total score can also be divided among the three subsets: PCS-R (0–16), PCS-H (0–12), and PCS-M (0–24).

Additional sources: Shirley Ryan AbilityLab, Physiopedia, and Oregon Health Authority

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