Evaluating the psychometric properties of the Widespread Pain Index and the Symptom Severity Scale in youth with painful conditions

Joanne Dudeney, Emily Law, Alagumeena Meyyappana, Tonya M. Palermo, Jennifer Rabbitts

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12 Citations (Scopus)
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Background: Assessing features of centralized pain may prove to be clinically meaningful in pediatric populations. However, we are currently limited by the lack of validated pediatric measures.
Aim: We examined the psychometric properties of the Widespread Pain Index (WPI) and Symptom Severity (SS) scale to assess features of centralized pain in youth with painful conditions from three clinical samples: (1) musculoskeletal surgery, (2) headache, and (3) chronic pain.
Methods: Participants were 240 youth aged 10 to 18 years (Mage = 14.8, SD = 1.9) who completed the WPI and SS scale. Subsets of participants also completed additional measures of pain region, pain intensity, quality of life, pain interference, and physical function.
Results: Increased features of centralized pain by age were seen for the WPI (r = 0.27, P < 0.01) and SS scale (r = 0.29, P < 0.01). Expected differences in sex were seen for the WPI (sex: t132 = −3.62, P < 0.01) but not the SS scale (sex: t223 = −1.73, P = 0.09). Reliability for the SS scale was adequate (α = 0.70). Construct validity was demonstrated through relationships between the WPI and pain regions (r = 0.57, P < 0.01) and between the SS scale and quality of life (r = −0.59, P < 0.01) and pain interference (r = 0.56, P < 0.01). Criterion validity was demonstrated by differences on the WPI between the surgery sample and the headache and chronic pain samples (F2,237 = 17.55, P < 0.001). Comprehension of the SS scale items was problematic for some youth.
Conclusions: The WPI showed adequate psychometric properties in youth; however, the SS scale may need to be modified. Our findings support the need to develop psychometrically sound instruments for comprehensive assessment of pain in pediatric samples.
Original languageEnglish
Pages (from-to)137-147
Number of pages11
JournalCanadian Journal of Pain
Issue number1
Publication statusPublished - 2019
Externally publishedYes

Bibliographical note

Copyright the Author(s) 2019. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • chronic pain
  • child
  • centralised pain
  • pain distribution
  • pain location
  • widespread pain
  • centralized pain


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