Are visual analogue scales valid instruments to measure psychological pain in psychiatric patients?

ElsevierVolume 358, 1 August 2024, Pages 150-156Journal of Affective DisordersAuthor links open overlay panel, ,

Study Group on Mental Pain

Highlights•

Validity of psychological and physical pain visual analogue scale (PPP-VAS) was investigated.

PPP-VAS showed convergent validity with the Orbach and the Holden psychological pain scales.

PPP-VAS showed discriminant validity with depression, hopelessness and physical pain.

PPP-VAS was related with recent suicidal ideation and suicide attempt.

PPP-VAS is an easy to use scale useful to evaluate suicidal risk in clinical settings.

AbstractObjective

The Psychological-Physical-Pain Visual Analogue Scale (PPP-VAS) was thought to probably help in identifying patients at risk of suicide. However, no data on its validity to measure psychological pain was available. Our main aim was to investigate the convergent validity of the PPP-VAS using two well-validated scales of psychological pain, the Orbach and Mikulincer Mental Pain scale (OMMP) and the Holden et al. Psychache Scale.

Methods

This multicentre study recruited a total of 1618 adult psychiatric inpatients and outpatients in Italy. Psychological pain was evaluated using the OMMP, Holden et al., and PPP-VAS scales. Psychiatric status, suicidal status, physical pain, depression, and hopelessness were also assessed.

Results

A structural equation model (SEM) using the items of psychological pain from the PPP-VAS showed that items loaded significantly on the psychological pain factor and showed good fit. Similarly, a second SEM model using the three scales of psychological pain showed acceptable fit and converged into a psychological pain construct. Correlations between the PPP-VAS and depression, hopelessness, and physical pain showed moderate correlations (r = 0.43 to r = 0.67). Finally, psychological pain evaluated with the PPP-VAS was significantly related with recent suicidal ideation in all patients (OR [95 % CI] = 1.07 [1.05, 1.09]) and recent suicide attempts in moderately to severely depressed patients, OR [95 % CI] = 1.01 [1.02, 1.03].

Conclusion

The PPP-VAS showed good psychometric properties in evaluating psychological pain. The characteristics of the PPP-VAS makes this scale a great option for its use in clinical practice to detect patients at risk of suicide.

Keywords

Psychological pain

Visual analogue scale

Validation

Suicide attempt

Suicidal ideation

© 2024 The Authors. Published by Elsevier B.V.

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