The pain beliefs questionnaire: an investigation of beliefs in the causes and consequences of pain

This paper reports the development and validation of the Pain Beliefs Questionnaire (PBQ). This is a 20-item questionnaire covering beliefs about the cause and treatment of pain. It was administered to 294 subjects, comprising 100 chronic pain patients and 194 controls. An exploratory factor analysis revealed 2 factors accounting for 68.15% of the variance. From the final solution 2 scales were derived: the first called Organic Beliefs and the second Psychological Beliefs scale, comprising 8 and 4 items, respectively. The construct validity of the questionnaire was assessed in 2 ways. First, the responses of chronic pain patients and non-patient controls were compared: a significant difference (F(1,236) = 53.04, P < 0.0001) between these 2 groups emerged such that chronic pain patients were more likely to endorse the Organic Beliefs scale items, whereas non-patients were more likely to endorse the Psychological Beliefs scale items. Secondly, as predicted significant associations were observed between scores on the Organic Beliefs scale and scores on the Chance and Powerful Others scales of the Multidimensional Health Locus of Control (MHLC), and also between the Psychological Beliefs and Internal scales of the MHLC. No relationship, however, emerged between these scales and measures of pain intensity. The implications of these findings for the assessment and management of chronic pain patients, and in the understanding of the development of chronic pain, are discussed.