Background: In medical psychology, the Brief Pain Inventory (BPI) allows for a separate assessment of pain intensity (scales of worst, least, and average pain) and of daily functional limitations due to pain (impairments of mood, ability to walk, work, interpersonal relations, sleep, and enjoyment of life). The present study evaluates the convergent validity of BPI’s measure of such functional limitations by calculating its correlations to other relevant clinical measures of psychological impairments caused by motor vehicle accidents (MVAs).
Method: De-identified archival data were available on 50 persons injured in MVAs (age 20 to 86 years, mean=42.1 years, SD=16.4; 23 males, 27 females). Their MVA occurred 11 to 280 weeks prior to psychological testing with the BPI (average time lapse 73.3 weeks, SD=53.8). All patients were still experiencing active post-MVA symptoms requiring medical attention and therapy. With respect to convergent validity, we examined Pearson correlations of the BPI to the Insomnia Severity Index (ISI), Rivermead Post-Concussion Symptoms Scale, Subjective Neuropsychological Symptoms Scale (SNPSS), and to measures of depression, anger, and anxiety (Items 10 to 12 of the Whiplash Disability Questionnaire).
Results: Functional interference of pain with daily activities (sum of BPI Items 9B to 9G) correlated significantly at p<0.05, 2-tailed with Rivermead post-concussion scores (r=0.39), post-MVA subjective neuropsychological symptoms (r=0.45), insomnia scores (r=0.41), and ratings of depression (r=0.52), anger (r=0.46), and anxiety (r=0.44). When the sum of BPI ratings of worst, least, and average pain was added to the functional interference/limitations score, then this sum of 9 BPI items correlated significantly at p<0.05, 2-tailed with Rivermead post-concussion scores (r=0.36), post-MVA subjective neuropsychological symptoms (r=0.46), insomnia scores (r=0.37), and ratings of depression (r=0.53), anger (r=0.50), and anxiety (r=0.40).
Discussion and Conclusion: The results lend support to convergent validity of the BPI when applied to persons injured in vehicular accidents.
C.S. Cleeland, “The Brief Pain Inventory - User Guide,” Houston, TX: The University of Texas M. D. Anderson Cancer Center, 2009.
C.S. Cleeland, & K.M. Ryan, “Pain assessment: Global use of the Brief Pain Inventory,” Annals, Academy of Medicine, Singapore. 1994;23(2):129-138.
C.Y. Song, S.F. Lin, C.Y. Huang, H.C. Wu, C.H. Chen, C.L. Hsieh, “Validation of the Brief Pain Inventory in Patients With Low Back Pain,” Spine. 2016;41(15):E937-E942.
G. Newshan, M. Lefkowitz, “Transdermal fentanyl for chronic pain in AIDS: a pilot study.” Journal of Pain and Symptom Management. 2001;21910:69-77.
G. Tan, M.P. Jensen, J.I. Thornby, B.F. Shanti, “Validation of the brief pain inventory for chronic nonmalignant pain,” The Journal of Pain. 2004;5(2):133-137. https://doi.org/10.1016/j.jpain.2003.12.005.
S. Keller, C.M. Bann, S.L. Dodd, J. Schein, T.R. Mendoza, C.S. Cleeland, “Validity of the Brief Pain Inventory for Use in Documenting the Outcomes of Patients With Noncancer Pain,” The Clinical Journal of Pain. 2004;20(5):309-318.
American Educational Research Association, American Psychological Association, National Council on Measurement in Education, “The Standards for Educational and Psychological Testing,” Washington, DC.: AERA Publications, 2014.
N.S. King, S. Crawford, F.J. Wenden, N.E.G. Moss, D.T. Wade, “The Rivermead Post Concussion Symptoms Questionnaire: a measure of symptoms commonly experienced after head injury and its reliability,” Journal of Neurology. 1995;242:587-592.
Z.Z. Cernovsky, S.C. Mann, V. Velamoor, L.K. Oyewumi, D.M. Diamond, and L.C. Litman, “Validation of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) on Patients Injured in High Impact Car Accidents,” Archives of Psychiatry and Behavioral Sciences. 2021;4(1):14-22. doi.org/10.22259/2638-5201.0401003.
Z.Z. Cernovsky, L.C. Litman, S.C. Mann, L.K. Oyewumi, Y. Bureau, J.D. Mendonça, D.M. Diamond, H. Raheb, “Validation of the Subjective Neuropsychological Symptoms Scale (SNPSS) in Injured Motorists,” Archives of Psychiatry and Behavioral Sciences. 2021;4(1):6-13. doi: 10.22259/2638-5201.0401002.
Z.Z. Cernovsky, S.C. Mann, V.R. Velamoor, and L.K. Oyewumi, “The Need for Three Separate Parallel WAD Ratings of Whiplash Injuries to Cervical, Lumbosacral, and Thoracic Spine in Clinical Assessments of Injured Motorists,” European Journal of Medical and Health Sciences. 2021;3(1):1-6. doi: 10.24018/ejmed.2021.3.1.699.
C.M. Morin, G. Belleville, L. Bélanger, H. Ivers, “The insomnia severity index: psychometric indicators to detect insomnia cases and evaluate treatment response,” Sleep. 2011;34(5):601-8.
M. Pinfold, K.R. Niere, E.F. O’Leary, J.L. Hoving, S. Green, R. Buchbinder, “Validity and internal consistency of a whiplash-specific disability measure,” Spine (Philadelphia, Pa, 1976). 2004;29(3):263-8.