Brief Psychological Screening Questions can be Useful for Ruling Out Psychological Conditions in Patients with Chronic Pain

Objectives: Psychological symptoms are highly prevalent in chronic pain patients. Timely and accurate identification may enable individualized treatment and improve outcomes. The aims of this study were to (1) investigate the concurrent validity of brief psychological screening questions assessing a...

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Main Authors: Vaegter, H., Handberg, G., Kent, Peter
Format: Journal Article
Published: 2017
Online Access:http://hdl.handle.net/20.500.11937/63504
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author Vaegter, H.
Handberg, G.
Kent, Peter
author_facet Vaegter, H.
Handberg, G.
Kent, Peter
author_sort Vaegter, H.
building Curtin Institutional Repository
collection Online Access
description Objectives: Psychological symptoms are highly prevalent in chronic pain patients. Timely and accurate identification may enable individualized treatment and improve outcomes. The aims of this study were to (1) investigate the concurrent validity of brief psychological screening questions assessing anxiety, fear of movement, stress, pain catastrophization, and depression in chronic pain patients, and (2) to determine screening question cut-points at which the likely probability of having these psychological states was <10%. Materials and Methods: Responses to 1-item or 2-item screening questions within each of these 5 psychological constructs were compared with those of validated full-length questionnaires in 894 patients with diverse chronic pain conditions. Results: Compared with scores from full-length questionnaires, brief screening question scores had correlations between 0.54 and 0.66, and area under the curve between 0.79 and 0.83. At the dichotomized threshold scores that we chose, the posttest probability after a negative test result ranged from 6.5% to 8.6% for all these psychological constructs, except fear of movement. The pretest probability was so high (70%) for fear of movement that no threshold resulted in a posttest probability (negative test result) that was below 10%. Discussion: Use of these screening tests and scoring thresholds would have correctly identified that between 38.5% and 60.5% of the sample were unlikely to have these psychological states (true negatives), with a false-negative rate between 3.4% and 5.3%. This would allow clinicians to focus on whether there are other patient attributes in those patients requiring more thorough investigation using comprehensive validated questionnaires or structured clinical interviews.
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spelling curtin-20.500.11937-635042019-03-15T05:42:46Z Brief Psychological Screening Questions can be Useful for Ruling Out Psychological Conditions in Patients with Chronic Pain Vaegter, H. Handberg, G. Kent, Peter Objectives: Psychological symptoms are highly prevalent in chronic pain patients. Timely and accurate identification may enable individualized treatment and improve outcomes. The aims of this study were to (1) investigate the concurrent validity of brief psychological screening questions assessing anxiety, fear of movement, stress, pain catastrophization, and depression in chronic pain patients, and (2) to determine screening question cut-points at which the likely probability of having these psychological states was <10%. Materials and Methods: Responses to 1-item or 2-item screening questions within each of these 5 psychological constructs were compared with those of validated full-length questionnaires in 894 patients with diverse chronic pain conditions. Results: Compared with scores from full-length questionnaires, brief screening question scores had correlations between 0.54 and 0.66, and area under the curve between 0.79 and 0.83. At the dichotomized threshold scores that we chose, the posttest probability after a negative test result ranged from 6.5% to 8.6% for all these psychological constructs, except fear of movement. The pretest probability was so high (70%) for fear of movement that no threshold resulted in a posttest probability (negative test result) that was below 10%. Discussion: Use of these screening tests and scoring thresholds would have correctly identified that between 38.5% and 60.5% of the sample were unlikely to have these psychological states (true negatives), with a false-negative rate between 3.4% and 5.3%. This would allow clinicians to focus on whether there are other patient attributes in those patients requiring more thorough investigation using comprehensive validated questionnaires or structured clinical interviews. 2017 Journal Article http://hdl.handle.net/20.500.11937/63504 10.1097/AJP.0000000000000514 fulltext
spellingShingle Vaegter, H.
Handberg, G.
Kent, Peter
Brief Psychological Screening Questions can be Useful for Ruling Out Psychological Conditions in Patients with Chronic Pain
title Brief Psychological Screening Questions can be Useful for Ruling Out Psychological Conditions in Patients with Chronic Pain
title_full Brief Psychological Screening Questions can be Useful for Ruling Out Psychological Conditions in Patients with Chronic Pain
title_fullStr Brief Psychological Screening Questions can be Useful for Ruling Out Psychological Conditions in Patients with Chronic Pain
title_full_unstemmed Brief Psychological Screening Questions can be Useful for Ruling Out Psychological Conditions in Patients with Chronic Pain
title_short Brief Psychological Screening Questions can be Useful for Ruling Out Psychological Conditions in Patients with Chronic Pain
title_sort brief psychological screening questions can be useful for ruling out psychological conditions in patients with chronic pain
url http://hdl.handle.net/20.500.11937/63504