Corrigendum: Self-Criticism: A Measure of Uncompassionate Behaviors Toward the Self, Based on the Negative Components of the Self-Compassion Scale.

[This corrects the article DOI: 10.3389/fpsyg.2016.01281.].

Self-Criticism: A Measure of Uncompassionate Behaviors Toward the Self, Based on the Negative Components of the Self-Compassion Scale.

BACKGROUND: The use of the Self-Compassion Scale (SCS) as a single measure has been pointed out as problematic by many authors and its originally proposed structure has repeatedly been called into question. The negative facets of this construct are more strongly related to psychopathology than the positive indicators. The aim of this study was to evaluate and compare the different structures proposed for the SCS, including a new measure based only on the negative factors, and to assess the psychometric features of the more plausible solution. METHOD: The study employed a cross-sectional and cross-cultural design. A sample of Brazilian (n = 406) and Spanish (n = 416) primary care professionals completed the SCS, and other questionnaires to measure psychological health-related variables. The SCS factor structure was estimated using confirmatory factor analysis by the maximum likelihood method. Internal consistency was assessed by squaring the correlation between the latent true variable and the observed variables. The relationships between the SCS and other constructs were analyzed using Spearman's r s . RESULTS: The structure with the best fit was comprised of the three negative first-order factors of "self-judgment", "isolation" and "over-identification", and one negative second-order factor, which has been named "self-criticism" [CFI = 0.92; RMSEA = 0.06 (90% CI = 0.05-0.07); SRMR = 0.05]. This solution was supported by both samples, presented partial metric invariance [CFI = 0.91; RMSEA = 0.06 (90% CI = 0.05-0.06); SRMR = 0.06], and showed significant correlations with other health-related psychological constructs. Reliability was adequate for all the dimensions (R ≥ 0.70). CONCLUSIONS: The original structure proposed for the SCS was not supported by the data. Self-criticism, comprising only the negative SCS factors, might be a measure of uncompassionate behaviors toward the self, with good psychometric properties and practical implications from a clinical point of view, reaching a stable structure and overcoming possible methodological artifacts.

Zen meditation, Length of Telomeres, and the Role of Experiential Avoidance and Compassion.

Mindfulness refers to an awareness that emerges by intentionally focusing on the present experience in a nonjudgmental or evaluative manner. Evidence regarding its efficacy has been increasing exponentially, and recent research suggests that the practice of meditation is associated with longer leukocyte telomere length. However, the psychological mechanisms underlying this potential relationship are unknown. We examined the telomere lengths of a group of 20 Zen meditation experts and another 20 healthy matched comparison participants who had not previously meditated. We also measured multiple psychological variables related to meditation practice. Genomic DNA was extracted for telomere measurement using a Life Length proprietary program. High-throughput quantitative fluorescence in situ hybridization (HT-Q-FISH) was used to measure the telomere length distribution and the median telomere length (MTL). The meditators group had a longer MTL (p = 0.005) and a lower percentage of short telomeres in individual cells (p = 0.007) than those in the comparison group. To determine which of the psychological variables contributed more to telomere maintenance, two regression analyses were conducted. In the first model, which applied to the MTL, the following three factors were significant: age, absence of experiential avoidance, and Common Humanity subscale of the Self Compassion Scale. Similarly, in the model that examined the percentage of short telomeres, the same factors were significant: age, absence of experiential avoidance, and Common Humanity subscale of the Self Compassion Scale. Although limited by a small sample size, these results suggest that the absence of experiential avoidance of negative emotions and thoughts is integral to the connection between meditation and telomeres.

Short-term improvement following dry needle stimulation of tender points in fibromyalgia.

The purpose of this study was to evaluate the short-term efficacy of dry needling therapy in patients severely affected by fibromyalgia. One hundred and twenty fibromyalgia patients were randomly divided into two groups. The control group, 56 women and 4 men, and the dry needling group, 54 women and 6 men, who apart from continuing their medical treatment, also underwent weekly 1-h session of dry needling for 6 weeks. At the beginning of the program, there were significant differences in the age (mean 56.26 years in the dry needling group versus 50.82 years in controls, p = 0.01) and McGill Pain Questionnaire [MPQ] (mean 39.07 in dry needling group versus 42.44 in controls, p = 0.03). At the end of treatment, the experimental group showed significant differences in most tests, including Visual Analogue Scale (VAS) of pain (p = 0.002), VAS of fatigue (p = 0.02), pain of Medical Outcomes Survey Short Form-36 (SF-36) (p = 0.0007), myalgic score (p = 0.0005), pressure pain threshold (p = 0.002), and global subjective improvement (p = 0.00001). Six weeks after the end of the treatment, the dry needling group still showed significant differences in most tests, including VAS of pain (p = 0.01), VAS of fatigue (p = 0.02), pain of SF-36 (p = 0.01), myalgic score (p = 0.00001), pressure pain threshold (p = 0.0004), and global subjective improvement (p = 0.00001). In conclusion, patients severely affected by fibromyalgia can obtain short-term improvements following weekly dry needling for 6 weeks.

Validation of a Spanish version of the psychological inflexibility in pain scale (PIPS) and an evaluation of its relation with acceptance of pain and mindfulness in sample of persons with fibromyalgia.

BACKGROUND: Psychological flexibility has been suggested as a fundamental process in health. The Psychological Inflexibility in Pain Scale (PIPS) is one of the scales employed for assessing psychological inflexibility in pain patients. The aim of this study was to validate the Spanish version of the PIPS and secondly, to compare it to two other psychological constructs, the acceptance of pain and mindfulness scales. METHODS: The PIPS was translated into Spanish by two bilingual linguistic experts, and then, back-translated into English to assess for equivalence. The final Spanish version was administered along with the Pain Visual Analogue Scale, Fibromyalgia Impact Questionnaire, Hospital Anxiety Depression Scale, Pain Catastrophizing Scale, Chronic Pain Acceptance Questionnaire and the Mindful Attention Awareness Scale, to 250 Spanish patients with fibromyalgia. Face validity, construct validity, reliability (internal consistency and test-retest) and convergent validity were tested. Also a multiple regression analysis was carried out.The usual guidelines have been followed for cross-cultural adaptations. RESULTS: Data were very similar to the ones obtained in the original PIPS version. The construct validity confirmed the original two-components solution which explained 61.6% of the variance. The Spanish PIPS had good test-retest reliability (intraclass correlation coefficient 0.97) and internal consistency reliability (Cronbach's alpha: 0.90). The Spanish PIPS' score correlated significantly with worse global functioning (r = 0.55), anxiety (r = 0.54), depression (r = 0.66), pain catastrophizing (r = 0.62), pain acceptance (r = -0.72) and mindfulness (r = -0.47), as well as correlating modestly with pain intensity (r = 0.12). The multiple regression analyses showed that psychological inflexibility, acceptance and mindfulness are not overlapped. CONCLUSIONS: The Spanish PIPS scale appears to be a valid and reliable instrument for the evaluation of psychological inflexibility among a sample of fibromyalgia patients. These results ensure the use of this scale in research as well as in clinical practice. Psychological inflexibility measures processes different from other related components such as acceptance and mindfulness.

Short-term efficacy of topical capsaicin therapy in severely affected fibromyalgia patients.

The purpose of this study was to evaluate the short-term efficacy of topical capsaicin treatment in patients severely affected by fibromyalgia. One hundred and thirty fibromyalgia patients were randomly divided into two groups. The control group, 56 women and 4 men who continued their medical treatment, and the capsaicin group, 70 women who apart from continuing their medical treatment, also underwent topical capsaicin 0.075 % 3 times daily for 6 weeks. At the beginning of the program, there were no significant differences between the two groups in any of the analyzed parameters. At the end of the treatment, there were significant improvements in the capsaicin group in the myalgic score (5.21 vs 3.8, p = 0.02) and global subjective improvement (22.8 vs 5 %, p = 0.001). Six weeks after the end of the treatment, the experimental group showed significant differences in Visual Analogue Scale of depression (5.63 vs 7.35, p = 0.02), Fibromyalgia Impact Questionnaire (67.89 vs 77.7, p = 0.02), role limitations due to emotional problems (36.17 vs 17.2, p = 0.05), Fatigue Severity Scale (6.2 vs 6.6, p = 0.04), myalgic score (3.94 vs 2.66, p = 0.02) and pressure pain threshold (79.25 vs 56.71, p = 0.004). In conclusion, patients severely affected by fibromyalgia can obtain short-term improvements following topical capsaicin 0.075 % treatment three times daily for 6 weeks.

Perceived injustice in fibromyalgia: psychometric characteristics of the Injustice Experience Questionnaire and relationship with pain catastrophising and pain acceptance.

OBJECTIVE: To validate a Spanish version of the Injustice Experience Questionnaire (IEQ), a measure of perceived injustice, in a fibromyalgia sample and to examine its relationship with pain catastrophising and pain acceptance. METHODS: The IEQ was administered along with the Pain Visual Analogue Scale, the Fibromyalgia Impact Questionnaire, the Hospital Anxiety and Depression Scale, the Pain Catastrophizing Scale (PCS) and the Chronic Pain Acceptance Questionnaire (CPAQ) to 250 primary care patients with fibromyalgia. RESULTS: The IEQ had good test-retest reliability (intraclass correlation coefficient=0.98) and internal consistency (Cronbach's α=0.92). The factor structure obtained was similar to the original validation study. The multiple regression analyses showed that perceived injustice (PI) accounted for significant pain-related outcomes after controlling pain intensity, PCS and CPAQ. Principal component analysis of both the IEQ and the CPAQ taken together showed that the two constructs do not represent opposite extremes of the same dimension. CONCLUSION: The IEQ is a reliable assessment tool for measuring PI among patients with fibromyalgia. PI seems to be distinct from catastrophising, although the two constructs are very similar. The factor analysis showed that PI and acceptance represent related constructs, and this entails relevant implications for therapy, as acceptance-based interventions would be appropriate.

Effectiveness of cognitive behaviour therapy for the treatment of catastrophisation in patients with fibromyalgia: a randomised controlled trial.

INTRODUCTION: No randomised, controlled trials have been conducted to date on the efficacy of psychological and pharmacological treatments of pain catastrophising (PC) in patients with fibromyalgia. Our aim in this study was to assess the effectiveness of cognitive-behaviour therapy (CBT) and the recommended pharmacological treatment (RPT) compared with treatment as usual (TAU) at the primary care level for the treatment of PC in fibromyalgia patients. METHODS: We conducted a six-month, multicenter, randomized, blinded, parallel group, controlled trial in which patients were randomly assigned to one of three study arms: CBT (n = 57), RPT (n = 56) and TAU at the primary care level (n = 56). The major outcome of this study was PC in patients with fibromyalgia. The secondary variables were pain acceptance, depression, anxiety, pain, global function and quality of life. RESULTS: CBT significantly decreased global PC at the six-month follow-up examination with effect sizes of Cohen's d = 0.73 and 1.01 compared with RPT and TAU, respectively. CBT was also more effective than RPT and TAU at increasing pain acceptance at the six-month follow-up examination (effect sizes of Cohen's d = 0.77 and 0.80, respectively). Compared with RPT and TAU, CBT was more effective at improving global function based on the Fibromyalgia Impact Questionnaire (six-month effect sizes Cohen's d = 0.44 and 0.53, respectively) and quality of life based on the European Quality of Life Scale (six-month effect sizes Cohen's d = 0.11 and 0.40, respectively). There were no differences among the three treatments with regard to pain and depression. CONCLUSIONS: CBT shows higher efficacy than RPT and TAU not only in key outcomes in FM, such as function and quality of life, but also in relevant mediators of treatment effects, such as pain catastrophising and pain acceptance. TRIAL REGISTRATION: ISRCTN: ISRCTN10804772.

Relationship between behavioural coping strategies and acceptance in patients with fibromyalgia syndrome: elucidating targets of interventions.

BACKGROUND: Previous research has found that acceptance of pain is more successful than cognitive coping variables for predicting adjustment to pain. This research has a limitation because measures of cognitive coping rely on observations and reports of thoughts or attempts to change thoughts rather than on overt behaviours. The purpose of the present study, therefore, is to compare the influence of acceptance measures and the influence of different behavioural coping strategies on the adjustment to chronic pain. METHODS: A sample of 167 individuals diagnosed with fibromyalgia syndrome completed the Chronic Pain Coping Inventory (CPCI) and the Chronic Pain Acceptance Questionnaire (CPAQ). RESULTS: Correlational analyses indicated that the acceptance variables were more related to distress and functioning than were behavioural coping variables. The average magnitudes of the coefficients for activity engagement and pain willingness (both subscales of pain acceptance) across the measures of distress and functioning were r = 0.42 and 0.25, respectively, meanwhile the average magnitude of the correlation between coping and functioning was r = 0.17. Regression analyses examined the independent, relative contributions of coping and acceptance to adjustment indicators and demonstrated that acceptance accounted for more variance than did coping variables. The variance contributed by acceptance scores ranged from 4.0 to 40%. The variance contributed by the coping variables ranged from 0 to 9%. CONCLUSIONS: This study extends the findings of previous work in enhancing the adoption of acceptance-based interventions for maintaining accurate functioning in fibromyalgia patients.

Correlational analysis and predictive validity of psychological constructs related with pain in fibromyalgia.

BACKGROUND: Fibromyalgia (FM) is a prevalent and disabling disorder characterized by a history of widespread pain for at least three months. Pain is considered a complex experience in which affective and cognitive aspects are crucial for prognosis. The aim of this study is to assess the importance of pain-related psychological constructs on function and pain in patients with FM. DESIGN: Multicentric, naturalistic, one-year follow-up study. SETTING AND STUDY SAMPLE: Patients will be recruited from primary care health centres in the region of Aragon, Spain. Patients considered for inclusion are those aged 18-65 years, able to understand Spanish, who fulfil criteria for primary FM according to the American College of Rheumatology, with no previous psychological treatment. MEASUREMENTS: The variables measured will be the following: main variables (pain assessed with a visual analogue scale and with sphygmomanometer and general function assessed with Fibromyalgia Impact Questionnaire, and), psychological constructs (pain catastrophizing, pain acceptance, mental defeat, psychological inflexibility, perceived injustice, mindfulness, and positive and negative affect), and secondary variables (sociodemographic variables, anxiety and depression assessed with Hospital Anxiety and Depression Scale, and psychiatric interview assessed with MINI). Assessments will be carried at baseline and at one-year follow-up. MAIN OUTCOME: Pain Visual Analogue Scale. ANALYSIS: The existence of differences in socio-demographic, main outcome and other variables regarding pain-related psychological constructs will be analysed using Chi Square test for qualitative variables, or Student t test or variance analysis, respectively, for variables fulfilling the normality hypothesis. To assess the predictive value of pain-related psychological construct on main outcome variables at one-year follow-up, use will be made of a logistic regression analysis adjusted for socio-demographic and clinical variables. A Spearman Rho non-parametric correlation matrix will be developed to determine possible overlapping between pain-related psychological constructs. DISCUSSION: In recent years, the relevance of cognitive and affective aspects for the treatment of chronic pain, not only in FM but also in other chronic pain diseases, has been widely acknowledged. However, the relative importance of these psychological constructs, the relationship and possible overlapping between them, or the exact meaning of them in pain are not enough known.

Stages of chronicity in fibromyalgia and pain catastrophising: a cross-sectional study.

BACKGROUND: Fibromyalgia (FM) is a prevalent and disabling disorder characterised by widespread pain and other symptoms such as insomnia, fatigue and depression. Catastrophisation is considered to be a key clinical symptom in FM; however, few studies have investigated how contextual factors, such as catastrophisation, might contribute to the duration of the pain. The present research examined the relationship among pain, catastrophic thinking and FM impact, as a function of stage of chronicity. METHODS: In this cross-sectional study, the sample of 328 patients diagnosed with FM was divided into 3 groups based on level of chronicity: Group A (6 months to 2 years, N = 46); Group B (2-4 years, N = 59); and Group C (more than 4 years, N = 223). The three subscales of the Pain Catastrophising Scale (PCS), rumination, magnification, and helplessness, were used as predictors of dysfunction. The Fibromyalgia Impact Questionnaire and the McGill Pain Questionnaire were also administered. A hierarchical regression analysis was performed on the entire sample and, subsequently, for each group to determine the effect of the continuous process variables (castastrophising and pain) on the stages of chronicity. RESULTS: Total score and PCS subscales were strongly associated with pain and impact in all the stages of chronicity in FM patients (r = 0.27-0.73, p < 0.05). For Group A, a regression analysis revealed that rumination predicted FM impact beyond the variance accounted for by age and pain. Both magnification and helplessness predicted impact in Group B, and helplessness was a significant predictor of impact in Group C. CONCLUSION: These findings provide preliminary evidence that stage of chronicity is an important moderator of psychological vulnerability for FM impact and should be taken into account by tailoring psychological interventions.

Validation of the Spanish version of the Chronic Pain Acceptance Questionnaire (CPAQ) for the assessment of acceptance in fibromyalgia.

BACKGROUND: The aim of this study was to validate a Spanish version of the Chronic Pain Acceptance Questionnaire (CPAQ). Pain acceptance is the process of giving up the struggle with pain and learning to live a worthwhile life despite it. The Chronic Pain Acceptance Questionnaire (CPAQ) is the questionnaire most often used to measure pain acceptance in chronic pain populations. METHODS: A total of 205 Spanish patients diagnosed with fibromyalgia syndrome who attended our pain clinic were asked to complete a battery of psychometric instruments: the Pain Visual Analogue Scale (PVAS) for pain intensity, the Hospital Anxiety and Depression Scale (HADS), the Medical Outcome Study Short Form 36 (SF-36), the Pain Catastrophising Scale (PCS) and the Fibromyalgia Impact Questionnaire (FIQ). RESULTS: Analysis of results showed that the Spanish CPAQ had good test-retest reliability (intraclass correlation coefficient 0.83) and internal consistency reliability (Cronbach's alpha: 0.83). The Spanish CPAQ score significantly correlated with pain intensity, anxiety, depression, pain catastrophising, health status and physical and psychosocial disability. The Scree plot and a Principal Components Factor analysis confirmed the same two-factor construct as the original English CPAQ. CONCLUSION: The Spanish CPAQ is a reliable clinical assessment tool with valid construct validity for the acceptance measurement among a sample of Spanish fibromyalgia patients. This study will make it easier to assess pain acceptance in Spanish populations with fibromyalgia.

Análisis de correlación y validez predictiva de los constructos relacionados con el dolor en fibromialgia / No disponible

No disponible

Aspectos cognitivos y afectivos del dolor / Cognitive and affective aspects of pain

En la actualidad, la influencia de las variables cognitivas y emocionales en la percepción del dolor se encuentra fuera de toda duda, admitiéndose que tanto la intensidad como las características del dolor están influenciadas por el procesamiento cognitivo del individuo. El catastrofismo y la aceptación parecen ser los constructos psicológicos que mejor explican los resultados del tratamiento aplicado en patologías que cursan con dolor (p. ej.: fibromialgia), siendo más importantes, incluso, que la intensidad del dolor. Esta revisión tratará de describir los principales constructos cognitivos implicados en el dolor y cómo actúan (AU)

The influence of cognitive and emotional variables in the perception of pain is currently subject to no doubt, with the admittance that both the intensity and the characteristics of pain are influenced by the subject’s cognitive processing. Catastrophism and acceptance seem to be the psychological constructs that are better able to explain the results of treatment applied to pathologies that are accompanied by pain(e.g. fibromyalgia),sometime shaving more importance than even the intensity of pain. This review will attempt to describe the main cognitive constructs implicated in pain and the way they act (AU)

Effectiveness of the psychological and pharmacological treatment of catastrophization in patients with fibromyalgia: a randomized controlled trial.

BACKGROUND: Fibromyalgia is a prevalent and disabling disorder characterized by widespread pain and other symptoms such as insomnia, fatigue or depression. Catastrophization is considered a key clinical symptom in fibromyalgia; however, there are no studies on the pharmacological or psychological treatment of catastrophizing. The general aim of this study is to assess the effectiveness of cognitive-behaviour therapy and recommended pharmacological treatment for fibromyalgia (pregabalin, with duloxetine added where there is a comorbid depression), compared with usual treatment at primary care level. DESIGN: A multi-centre, randomized controlled trial involving three groups: the control group, consisting of usual treatment at primary care level, and two intervention groups, one consisting of cognitive-behaviour therapy, and the other consisting of the recommended pharmacological treatment for fibromyalgia. SETTING: 29 primary care health centres in the city of Zaragoza, Spain. SAMPLE: 180 patients, aged 18-65 years, able to understand and read Spanish, who fulfil criteria for primary fibromyalgia, with no previous psychological treatment, and no pharmacological treatment or their acceptance to discontinue it two weeks before the onset of the study. INTERVENTION: Psychological treatment is based on the manualized protocol developed by Prof. Escobar et al, from the University of New Jersey, for the treatment of somatoform disorders, which has been adapted by our group for the treatment of fibromyalgia. It includes 10 weekly sessions of cognitive-behaviour therapy. Pharmacological therapy consists of the recommended pharmacological treatment for fibromyalgia: pregabalin (300-600 mg/day), with duloxetine (60-120 mg/day) added where there is a comorbid depression). MEASUREMENTS: The following socio-demographic data will be collected: sex, age, marital status, education, occupation and social class. The diagnosis of psychiatric disorders will be made with the Structured Polyvalent Psychiatric Interview. Other instruments to be administered are the Pain Catastrophizing Scale, the Hamilton tests for Anxiety and for Depression, the Fibromyalgia Impact Questionnaire (FIQ), the EuroQuol-5 domains (EQ-5D), and the use of health and social services (CSRI). Assessments will be carried out at baseline, 1, 3, and 6 months. MAIN VARIABLE: Pain catastrophizing. ANALYSIS: The analysis will be per intent to treat. We will use the general linear models of the SPSS version 15 statistical package, to analyse the effect of the treatment on the result variable (pain catastrophizing). DISCUSSION: It is necessary to assess the effectiveness of pharmacological and psychological treatments for pain catastrophizing in fibromyalgia. This randomized clinical trial will determine whether both treatments are effective for this important prognostic variable in patients with fibromyalgia. TRIAL REGISTRATION: Current Controlled Trials ISRCTN10804772.

[Cognitive and affective aspects of pain]. / Aspectos cognitivos y afectivos del dolor.

The influence of cognitive and emotional variables in the perception of pain is currently subject to no doubt, with the admittance that both the intensity and the characteristics of pain are influenced by the subject's cognitive processing. Catastrophism and acceptance seem to be the psychological constructs that are better able to explain the results of treatment applied to pathologies that are accompanied by pain (e.g. fibromyalgia), sometimes having more importance than even the intensity of pain. This review will attempt to describe the main cognitive constructs implicated in pain and the way they act.

[Validation of the Spanish version of the Pain Catastrophizing Scale in fibromyalgia]. / Validación de la versión española de la escala de la catastrofización ante el dolor (Pain Catastrophizing Scale) en la fibromialgia.

BACKGROUND AND OBJECTIVE: Pain catastrophization is considered an important risk factor for pain in general and, specifically, for fibromyalgia. There are no validated Spanish versions of any of the questionnaires developed to assess pain catastrophization. The aim of this study was to validate the Spanish version of the Pain Catastrophization Scale (PCS), one of the most used questionnaires to assess pain catastrophization. PATIENTS AND METHOD: A prospective, observational and multicentre study was carried out in clinically stable and unstable patients with fibromyalgia. Factorial structure, convergent validity, reliability (internal consistency and test-retest) and sensitivity to change were assessed. RESULTS: Two hundred and thirty patients from 12 primary care health centres were included. The Spanish version of the PCS showed the same 3-factor structure (rumination, magnification and helplessness) described in the original study. It also showed appropriate internal consistency (Cronbach alpha=0.79), test-retest reliability (intraclass correlation coefficient=0.84) and sensitivity to change (effect size

Validación de la versión española de la escala de la catastrofización ante el dolor (Pain Catastrophizing Scale) en la fibromialgia / Validation of the Spanish version of the Pain Catastrophizing Scale in fibromyalgia

FUNDAMENTO Y OBJETIVO: La catastrofización ante el dolor se considera un factor pronóstico importante en el dolor crónico en general y en la fibromialgia en particular. No hay versiones españolas validadas de ninguna de las escalas desarrolladas para medirla. El objetivo de este estudio ha sido validar la versión española de la Pain Catastrophizing Scale (PCS), una de las escalas más utilizadas para medir este constructo. PACIENTES Y MÉTODO: Se ha realizado un estudio multicétrico, observacional y prospectivo en pacientes con fibromialgia clínicamente estables e inestables. Se evaluaron la estructura factorial,la validez convergente, la fiabilidad (consistencia interna y estabilidad temporal) y la sensibilidadal cambio de la escala. RESULTADOS: Se incluyó a 230 pacientes con fibromialgia de 12 centros de atención primaria de Zaragoza. La escala presentó la misma estructura factorial de 3 factores descritos en el estudio original (rumiación, magnificación y desesperanza), así como una adecuada consistencia inerna(alfa de Cronbach = 0,79), fiabilidad test-retest (coeficiente de correlación intraclase= 0,84) y sensibilidad al cambio (tamaño del efecto >= 2). CONCLUSIONES: La versión española de la PCS muestra adecuadas propiedades psicométricas, similaresa las de la escala original, por lo que su uso estaría indicado en la práctica asistencial y la investigación clínica en pacientes españoles con fibromialgia (AU)

BACKGROUND AND OBJECTIVE: Pain catastrophization is considered an important risk factor for painin general and, specifically, for fibromyalgia. There are no validated Spanish versions of any ofthe questionnaires developed to assess pain catastrophization. The aim of this study was to validatethe Spanish version of the Pain Catastrophization Scale (PCS), one of the most used questionnaires to assess pain catastrophization. PATIENTS AND METHOD: A prospective, observational and multicentre study was carried out in clinically stable and unstable patients with fibromyalgia. Factorial structure, convergent validity, reliability (internal consistency and test-retest) and sensitivity to change were assessed. RESULTS: Two hundred and thirty patients from 12 primary care health centres were included. The Spanish version of the PCS showed the same 3-factor structure (rumination, magnificationand helplessness) described in the original study. It also showed appropriate internal consistency (Cronbach alpha = 0.79), test-retest reliability (intraclass correlation coefficient = 0.84)and sensitivity to change (effect size >= 2). CONCLUSIONS: The Spanish version of the PCS shows appropriate psychometric properties, similarto the English original scale. Therefore, PCS could be useful for clinical practice and researchin Spanish patients with fibromyalgia (AU)