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A Rasch Analysis of the Pain Catastrophizing Scale Supports its Use as an Interval-level Measure

Walton, David M. BScPT, PhD*; Wideman, Timothy H. PhD; Sullivan, Michael J. L. PhD

The Clinical Journal of Pain: June 2013 - Volume 29 - Issue 6 - p 499–506
doi: 10.1097/AJP.0b013e318269569c
Original Articles

Objectives: To evaluate the properties of the Pain Catastrophizing Scale (PCS) from a Rasch paradigm.

Methods: A secondary analysis of 235 patients with work-related pain conditions was performed using the Rasch methodology. Unidimensionality, item fit, location independence, differential item functioning, response option structure, and linearity were evaluated for the 13-item PCS score.

Results: Two items (8 and 12) required rescoring to address disordered response thresholds. Significant misfit to the Rasch model was corrected through the use of testlets based on the original 3 factors of the PCS (rumination, magnification, and helplessness). After rescoring and creation of testlets, the scale showed good fit to the Rasch model (χ2=6.93, P=0.91) and could be logically considered an interval-level scale. No evidence of differential item functioning was found for sex or location of pain. The items in the scale covered the spectrum of catastrophizing levels reported by the sample. A transformation matrix is presented that allows simple conversion of ordinal to interval-level scores.

Discussion: The results of this secondary analysis suggest that the PCS can be appropriately evaluated as an interval-level scale when the composite 13-item score is considered, as has been standard practice to date. Implications for clinical and research use are discussed.

*Faculty of Health Sciences, The University of Western Ontario, London, ON

Department of Psychology, McGill University, Montreal, QC, Canada

Dr. Sullivan is the originator of the PCS. The other authors have no conflict of interest. No funding has been received specifically for this secondary analysis.

Reprints: David M. Walton, BScPT, PhD, Rm. EC1443, School of Physical Therapy, The University of Western Ontario, 1201 Western Rd. London, ON, Canada N6G 1A1 (e-mail:

Received December 12, 2011

Accepted July 11, 2012

© 2013 Lippincott Williams & Wilkins, Inc.