Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.02.057
Brazilian Journal of Anesthesiology
Original Investigation

Validation of the Brazilian version of the child pain catastrophizing scale and its relationship with a marker of central sensitization

Validação da versão brasileira da escala de catastrofização da dor infantil e sua relação com um marcador de sensibilização central

Larissa Schneider, Stela Maris de Jezus Castro, Eliza Saggin Mallman, Cibelle de Abreu Evaldt, Andressa Souza, Josy da Silva Rodrigues, Clarissa Mendanha, Wolnei Caumo, Luciana Cadore Stefani

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Abstract

Objectives
The Pain Catastrophizing Scale-Child version (PCS-C) allows to identify children who are prone to catastrophic thinking. We aimed to adapt the Brazilian version of PCS-C (BPCS-C) to examine scale psychometric properties and factorial structure in children with and without chronic pain. Also, we assessed its correlation with salivary levels of Brain-Derived Neurotrophic factor (BDNF).

Methods
The Brazilian version of PCS-C was modified to adjust it for 7–12 years old children. To assess psychometric properties, 100 children (44 with chronic pain from a tertiary hospital and 56 healthy children from a public school) answered the BPCS-C, the visual analogue pain scale, and questions about pain interference in daily activities. We also collected a salivary sample to measure BDNF.

Results
We observed good internal consistency (Cronbach’s value = 0.81). Parallel analysis retained 2-factors. Confirmatory factor analysis of our 2-factor model revealed consistent goodness-of-fit (IFI = 0.946) when compared to other models. There was no correlation between visual analogue pain scale and the total BPCS-C score; however, there was an association between pain catastrophizing and difficulty in doing physical activities in school (p =  0.01). BPCS-C total scores were not different between groups. We found a marginal association with BPCS-C (r = 0.27, p =  0.01) and salivary BDNF levels.

Discussion
BPCS-C is a valid instrument with consistent psychometric properties. The revised 2-dimension proposed can be used for this population. Children catastrophism is well correlated with physical limitation, but the absence of BPCS-C score differences between groups highlights the necessity of a better understanding about catastrophic thinking in children.

Keywords

Catastrophizing,  Pain catastrophizing,  Chronic pain,  Validation studies as topic,  Children,  Brain-Derived Neurotrophic Factor (BDNF)

Resumo

Objetivos: A Escala de Catastrofização da Dor – versão infantil (PCS-C) permite identificar crianças propensas ao pensamento catastrófico. Nosso objetivo foi adaptar a versão brasileira do PCS-C (BPCS-C) para examinar as propriedades psicométricas e a estrutura fatorial da escala em crianças com e sem dor crônica. Além disso, avaliamos sua correlação com os níveis salivares do fator neurotrófico derivado do cérebro (BDNF). Métodos: A versão brasileira do PCS-C foi modificada para ajustá-la para crianças de 7 a 12 anos. Para avaliar as propriedades psicométricas, 100 crianças (44 com dor crônica de um hospital terciário e 56 crianças saudáveis de uma escola pública) responderam a BPCS-C, a escala visual analógica de dor e questões sobre a interferência da dor nas atividades diárias. Também coletamos uma amostra salivar para medir o BDNF. Resultados: Observamos boa consistência interna (valor de Cronbach: 0,81). A análise paralela reteve 2 fatores. A análise fatorial confirmatória do nosso modelo de 2 fatores revelou uma qualidade de ajuste consistente (IFI=0,946) quando comparada a outros modelos. Não houve correlação entre a escala visual analógica de dor e a pontuação total do BPCS-C; porém, houve associação entre catastrofização da dor e dificuldade em realizar atividades físicas na escola (p = 0,01). Os escores totais da BPCS-C não foram diferentes entre os grupos. Encontramos uma associação marginal com BPCS-C (r = 0,27 p = 0,01) e níveis salivares de BDNF. Discussão: O BPCS-C é um instrumento válido com propriedades psicométricas consistentes. A proposta bidimensional revisada pode ser usada para esta população. O catastrofismo infantil está bem correlacionado com a limitação física, mas a ausência de diferenças na pontuação BPCS-C entre os grupos destaca a necessidade de uma melhor compreensão sobre o pensamento catastrófico em crianças.

Palavras-chave

Catastrofização; Catastrofização da dor; Dor crônica; Estudos de validação como tema; Crianças; Fator Neurotrófico Derivado do Cérebro (BDNF)

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