Development and validation of a multidimensional psychometric scale for assessing pain perception and coping strategies among adolescents

Abstract

Objectives: Pain is a common experience during childhood and adolescence influencing emotional well-being, social functioning, and academic performance. Currently, there is a lack of rigorously validated multidimensional tools specifically designed for adolescents that can simultaneously assess pain sensitivity, its social–emotional impact, and pain acceptance.

Methods: A sample of 836 adolescents completed the Adolescent Pain Sensitivity, Impact, and Acceptance Scale (APSIA) and the Chinese version of the Pain Sensitivity Questionnaire (PSQ) in Jiangxi Province, China (October 2023). The instrument was developed through experts’ consultations and literature review, followed by a pilot test. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), validity analyses against the PSQ, K-means clustering, and structural equation modeling (SEM) were conducted using R.

Results: The final APSIA was reduced to 18 items with three factors via EFA and CFA: pain sensitivity (8 items), social–emotional impact (6 items), and pain acceptance (4 items). The model demonstrated acceptable fit (CFI = 0.938, RMSEA = 0.072) and internal consistency (α > 0.80). Validity analyses against the PSQ showed statistically significant but small group differences (p = 0.003, d = 0.21) and a weak association with limited explained variance (R2 = 0.031). Cluster analysis revealed three pain response profiles with distinct patterns in pain sensitivity, social–emotional impact, and pain acceptance. SEM revealed a strong association between pain acceptance and social–emotional impact (standardized β = 0.805, p < 0.001). Alternative directional models yielded equivalent model fit (ΔAIC < 0.001), suggesting that causal direction cannot be determined from cross-sectional data.

Conclusion: The APSIA showed initial psychometric support for assessing pain experiences in adolescents. It may provide a useful foundation for early screening, psychological intervention, and personalized pain management. Future studies should evaluate its clinical utility, cross-cultural applicability, and long-term stability.