Developing a Linguistically Valid Japanese Version of the Chronic Pain Attribution Scale: Translation and Cultural Adaptation Process.

Abstract

Background: Patients' "pain attributions," or their beliefs about chronic pain causes, critically affect pain experience and recovery, potentially modulating responses to analgesics and psychotropics. Since many pain-mitigating drugs also impact psychological processes and brain functions underlying these attributions, such processes are relevant targets. The Chronic Pain Attribution Scale (CPAS) by Ashar et al. (2023) quantifies these beliefs. A Japanese version (CPAS-J) is needed to assess this psychologically relevant construct in Japanese populations. This study aimed to develop and linguistically validate the CPAS-J.

Methods: The CPAS-J was developed following International Society for Pharmacoeconomics and Outcomes Research guidelines, with permission from the original author. The process included forward translation by eight bilingual medical experts, reconciliation by a pain research team, back-translation by an independent translator, review by the original author, and a final consensus discussion to establish the definitive CPAS-J.

Results: The linguistic validation identified challenges in distinguishing "cause" from "trigger" in Japanese. To enhance comprehensibility, the team combined "kikkake" (initiating factor) and "gen'in" (broader cause/origin). The finalized CPAS-J assesses perceived causes of pain.

Conclusions: The CPAS-J was successfully developed through a rigorous process. This tool supports research on pain attributions in Japanese-speaking populations and may improve our understanding of treatment responses by assessing a key psychological dimension of chronic pain that is linked to brain-based processes.