The Pain Coping Questionnaire: preliminary validation.

A new measure of coping, the Pain Coping Questionnaire (PCQ), is presented and validated in two studies of children and adolescents. Factor analyses of data from healthy children and adolescents supported eight hypothesized subscales (information seeking, problem solving, seeking social support, positive self-statements, behavioral distraction, cognitive distraction, externalizing, internalizing/catastrophizing) and three higher-order scales (approach, problem-focused avoidance, emotion-focused avoidance). The subscales and higher-order scales were internally consistent. The pain coping scales were correlated in the expected directions with children's appraisals of pain controllability, self-rated coping effectiveness, emotional distress when in pain, and among high school students, pain thresholds and functional disability. The structure and internal consistency of the PCQ were replicated in a sample of children and adolescents experiencing recurrent pain (headache, arthritis), and their parents. Relations between child- and parent-ratings of children's coping were moderate (median r=0.34). Higher levels of emotion-focused avoidance were related to more emotional distress (both samples), less coping effectiveness (headache sample), and higher levels of pain (arthritis sample). Higher levels of approach coping were related to less disability (headache sample). Other relations between approach and distraction coping and the outcome variables were generally not significant. The PCQ is a promising instrument for assessing children's pain coping strategies. The items are simple and relatively few, making it useful for assessing coping across a wide age range. It can be administered to children as young as 8 years of age in approximately 15 min.