Clinical Journal of Pain最新文献

{"title":"Clinimetric Evaluation of the English Version of the Conceptualization of Pain Questionnaire (COPAQ).","authors":"Isabelle Bogard, Steven J Kamper, Kris Rogers, Tie P Yamato","doi":"10.1097/AJP.0000000000001377","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001377","url":null,"abstract":"<p><strong>Objective: </strong>Very few validated instruments measure a child's concept of pain. The Conceptualization of Pain Questionnaire (COPAQ) is a unidimensional instrument measuring this construct, developed in Catalan and translated to English. The psychometric properties of the English-version have not been evaluated. We conducted a Rasch analysis to evaluate its structural validity and internal consistency and a Confirmatory Factor Analysis (CFA) to evaluate its structural validity.</p><p><strong>Methods: </strong>We analysed an existing dataset from a previous study. Item fit was evaluated using INFIT and OUTFIT statistics, item difficulty was estimated using Rasch coefficients, and internal consistency using Cronbach's alpha. Structural validity was measured using item loadings from the CFA.</p><p><strong>Results: </strong>We included data from 497 adolescents (average age 14 y [SD 1.28], 51% male). There was a wide range of difficulty across items. One item demonstrated excessive positive outfit, and two items were close to the cut-off for excessive negative outfit. The COPAQ demonstrated poor overall fit to the unidimensional Rasch Model and did not demonstrate adequate internal consistency (Cronbach's alpha=0.6). Results from the CFA suggest the items do not measure the single construct they intend to measure.</p><p><strong>Discussion: </strong>The English-version of the COPAQ did not have adequate internal consistency or structural validity. More work is required to assess the content validity of current instruments measuring a child's concept of pain. Developing validated instruments measuring a child's concept of pain aligned with the biopsychosocial model should be prioritized.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methods for 2025 HELPinKids&Adults and Clinical Practice Guideline for Reducing Distress during Vaccination.","authors":"Anna Taddio, Vibhuti Shah, C Meghan McMurtry, Eddy Lang, Noni E MacDonald, Kaytlin Constantin, Elizabeth Uleryk","doi":"10.1097/AJP.0000000000001371","DOIUrl":"10.1097/AJP.0000000000001371","url":null,"abstract":"<p><p>Part of the June 2026 issue supplement, to be published in its entirety on May 12, 2026.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Depressive Symptoms and Pain-related Functioning Among Adolescents With Recurrent Musculoskeletal Pain. A Longitudinal Study.","authors":"Tove Axelsson-Landberg, Christiana Owiredua, Emma Nilsing-Strid, Anna Duberg, Katja Boersma","doi":"10.1097/AJP.0000000000001378","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001378","url":null,"abstract":"<p><strong>Background: </strong>Chronic musculoskeletal pain is reported by one of four adolescents worldwide. Pain-related functioning is negatively affected by pain itself but also related to depressive symptoms. While the association between pain-related functioning and depressive symptoms is established, there is a lack of longitudinal studies that establishes the direction of the association.</p><p><strong>Objectives: </strong>The aim was to analyse the temporal association between depressive symptoms and pain-related functioning among adolescents with recurrent musculoskeletal pain.</p><p><strong>Methods: </strong>This longitudinal sample comprised 604 adolescents in 7th and 8th grade (M = 13.7 years) who reported recurrent musculoskeletal pain at baseline, defined as occurring at least every week over the previous 6 months. The adolescents were followed yearly for two consecutive years (T1, T2 and T3). Temporal associations of self-reported pain-related functioning and depressive symptoms were analysed. Using cross-lagged panel modelling, four models were estimated: Autoregressive; Depressive symptoms predicting pain-related functioning; Pain-related functioning predicting depressive symptoms and a bidirectional model. Pain intensity was entered as a covariate.</p><p><strong>Results: </strong>The results indicate high stability of depressive symptoms and pain-related functioning over time. While the strength of the prediction was strongest in the autoregressive paths, cross-lagged paths revealed that depressive symptoms at T1 and T2 significantly predicted pain-related functioning at T2 respectively T3. Conversely, pain-related functioning at T1 and T2 did not predict depressive symptoms at T2 respectively T3.</p><p><strong>Conclusions: </strong>The model where depressive symptoms predict pain-related functioning provided the best model fit and thus, in this general population sample, depressive symptoms drive pain-related functioning more than vice versa. Screening for, and targeting depressive symptoms, might be essential in affecting the functional consequences of pain.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Interdisciplinary Young Adult Pain Rehabilitation Program: Initial Outcomes Supporting Effectiveness.","authors":"Leah Reece, Morgan Mitcheson, Carolina Donado, Julie Shulman, Monique Ribeiro, Kevin Zirko, Roxanne DeFabio, Shealyn O'Donnell, Paige Brousseau, Lisa Volpigno, Mahadeva Daniel, Sophia Paravalos, Kimberly Lobo, Mikayla Culpo, Deirdre Logan, Navil Sethna, Christine Greco","doi":"10.1097/AJP.0000000000001369","DOIUrl":"10.1097/AJP.0000000000001369","url":null,"abstract":"<p><strong>Context: </strong>Chronic pain affects 1 in 9 young adults worldwide. Intensive interdisciplinary pain treatment (IIPT) has shown favorable outcomes in pain intensity, mood, school attendance and social and physical functioning in pediatric studies.  However, few IIPT programs are designed for young adults (YAs), a distinctly vulnerable developmental stage. Given this limitation, we sought to study the benefits of applying an IIPT model for YAs with chronic pain and functional impairment.</p><p><strong>Objectives: </strong>This study aims to 1) describe the design and implementation of our pilot YA-IIPT program and 2) assess outcomes of YA-IIPT on pain experience, psychological and physical functioning, disability, and quality of life, in YAs with chronic pain and functional impairment.</p><p><strong>Methods: </strong>In this observational study, we adapted the pediatric IIPT model for YAs using a biopsychosocial approach to chronic pain treatment. Outcome measures included physical functioning, psychological functioning, disability and quality of life, and pain experience. Paired t-tests and repeated measure ANOVAs were used to compare admission, discharge, 6-week, and 6-month follow-up data.</p><p><strong>Results: </strong>Patients showed clinically and statistically significant improvements across the majority of physical and psychological functioning, disability, quality of life, and pain experience measures between admission and discharge ( P values<0.01). Most improvements were maintained at 6-week and 6-month follow-up.</p><p><strong>Discussion: </strong>On average, participants in our YA-IIPT program demonstrated clinically and statistically significant improvements in most areas of functioning, quality of life, and pain experience that were maintained after discharge. Further research is needed on YA pain treatment and whether outcomes after YA-IIPT are sustained long term.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Somatosensory Function and Pain: Associations Over 12 Months Postinjury in Youth With Acute Musculoskeletal Pain.","authors":"Amy L Holley, Sydnee Stoyles, Nathan F Dieckmann, Jessica Heierle, Jacqueline R O'Brien, Robert Edwards, Tonya M Palermo, Anna C Wilson","doi":"10.1097/AJP.0000000000001353","DOIUrl":"10.1097/AJP.0000000000001353","url":null,"abstract":"<p><strong>Objective: </strong>Acute musculoskeletal (MSK) injuries are common in youth and prior research has identified somatosensory experiences such as conditioned pain modulation (CPM) as a predictor of the transition from acute to chronic pain. Prior pediatric studies are limited by small samples, single quantitative sensory testing (QST) modalities, and short-term follow-up, so the utility of QST in predicting longer-term pain outcomes following acute injury is unknown. To fill this gap, we examined somatosensory function in the acute pain period as a predictor of pain outcomes over 12 months.</p><p><strong>Methods: </strong>Participants were 226 youth (and a caregiver) taking part in a prospective longitudinal study. Youth completed a QST battery (pain threshold, pain tolerance, temporal summation, and CPM) at baseline (postinjury), and questionnaires assessing pain (average pain, movement-evoked pain; MEP) at 3 time points over 12 months.</p><p><strong>Results: </strong>A subset of youth developed persistent pain (≥3/0 to 10 NRS) at 3 months (15% to 21% depending on pain measure). Regression models indicated CPM was the sole QST measure that predicted pain intensity and persistence at 3 months (both average and MEP). No QST measures predicted pain outcomes at 12 months. Female sex was associated with pain persistence in multiple models.</p><p><strong>Discussion: </strong>CPM in the acute pain period is a potential marker for short-term pain outcomes. Future research can examine the utility of using QST in predicting pain outcomes in other pediatric pain samples (eg, non-MSK locations, more severe injuries) and can expand assessment of MEP using standardized performance tasks.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13068294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Progress of Fentanyl.","authors":"Rui Feng","doi":"10.1097/AJP.0000000000001368","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001368","url":null,"abstract":"<p><strong>Objectives: </strong>Fentanyl, a potent μ receptor agonist, is a cornerstone of perioperative and cancer pain management due to its high efficiency and multi-dosage characteristics. Despite its efficacy, the risks of respiratory depression and abuse present significant global public health challenges. The development of novel drug delivery systems expands its utility but intensifies the need to balance clinical benefits with safety. This review synthesizes resent evidence on fentanyl pharmacology and clinical use,with a focus on multimodal administration strategies,does adjustment for special populations,and the impact of anti-abuse technologies and regulatory policies.</p><p><strong>Methods: </strong>From the establishment of the database to September 2025, researchers conducted a systematic literature search in PubMed, Embase and CNKI databases. The search terms included ' fentanyl ', ' analgesia ', ' pharmacokinetics ', ' respiratory depression ' and ' abuse prevention '. High-quality randomized controlled trials, meta-analysis, literature review and the latest clinical guidelines were included.</p><p><strong>Results: </strong>Analysis confirms that the fentanyl's unique pharmacokinetic and its newly discovered multivalent binding mode to the μ-receptor underpin its rapid onset and potent analgesia. Quantitative comparisons show intravenous administration excels in rapid-onset pain relief, while mucosal routes provide superior sustained drug exposure. Critically, does reduction is essential for elderly patients and those with hepatic impairment. The intergration of anti-abuse formulations and stringent regulatory measures is vital for mitigating misuse risks while ensuring medical accessibility.</p><p><strong>Discussion: </strong>The effective use of fentanyl resquires an integrated strategy combining pharmacological knowledge,individual patient factors,and a robust regulatory framework. The clinical decision-making pathway proposed herein aids in optimizing analgesia minimizing adverse outcomes.Future research should prioritize developing evidence-based guidelines for the Chinese population and exploring genomic predictors for personalized pain management.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in Defining Centralized Pain Following Peripheral Nerve Injury.","authors":"Antonio Alcántara Montero","doi":"10.1097/AJP.0000000000001365","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001365","url":null,"abstract":"","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Item Reduction and Scoring of the Pediatric PainSCAN ©: A Screening Tool for Pediatric Neuropathic Pain and Complex Regional Pain Syndrome.","authors":"Giulia Mesaroli, Aileen M Davis, Anthony V Perruccio, Kristen M Davidge, Fiona Campbell, Naiyi Sun, Suellen M Walker, Courtney W Hess, Laura E Simons, Deirdre Logan, Jennifer N Stinson","doi":"10.1097/AJP.0000000000001339","DOIUrl":"10.1097/AJP.0000000000001339","url":null,"abstract":"<p><strong>Objectives: </strong>The Pediatric PainSCAN© is the first screening tool specifically designed for pediatric neuropathic pain (NP) and complex regional pain syndrome (CRPS). A draft tool (37 items) was developed through a phased approach. This research aimed to reduce the number of items in the tool and to determine the weight of each item (ie, item scores) as it contributes to a probability of a diagnosis of NP or CRPS.</p><p><strong>Methods: </strong>Survey 1 was administered to patients with NP or CRPS and health care professionals (HCPs). Participants rated the frequency and importance of each item in the draft tool on a 0 to 4 Likert scale; highest rated items were retained. Survey 2 was administered to a separate pool of patients (with NP, CRPS, or other pain conditions) who completed the Pediatric PainSCAN©. A logistic regression model was used to examine the relationship between item responses (yes/no) and patient diagnosis; parameter estimates were used for item scores.</p><p><strong>Results: </strong>Survey 1 was completed by 43 patients (median age 15 y, 77% female) and 74 HCPs. Survey 2 was completed by 221 patients (median age 15 y, 81% female). Nineteen items remained in the final version of the tool; items were rated as important by patients and HCPs. Item scores are summed and converted to a probability score.</p><p><strong>Conclusion: </strong>The final set of items in the Pediatric PainSCAN© has been determined and study results provide further evidence of content validity. Additional research is needed to evaluate the tool's reliability, criterion validity, and select a cutoff score.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpretation of the Avoidance-endurance Fast-screen Questionnaire: A Qualitative Study Using Cognitive Interviews in Patients with High-impact Chronic Pain.","authors":"Line Marie Saugmann Razniak, Henrik Bjarke Vægter, Andrea Aagaard, Tonny Elmose Andersen, Monika Irene Hasenbring, Maria Lund Rasmussen, Sophie Lykkegaard Ravn","doi":"10.1097/AJP.0000000000001356","DOIUrl":"10.1097/AJP.0000000000001356","url":null,"abstract":"<p><strong>Objectives: </strong>This study examined how patients with high-impact chronic pain interpreted and responded to the Danish version of the Avoidance-Endurance Fast-Screen (AE-FS) to identify potential problematic items that did not correspond with item intention and causes for this.</p><p><strong>Methods: </strong>Participants were recruited from patients referred to treatment in an interdisciplinary pain center to partake in cognitive interviews following the Three-Step Test-Interview protocol. Interview transcripts were analyzed in two steps. First, a coding analysis was used to code responses in relation to item intention using four predefined codes (congruent, incongruent, ambiguous, or confused) to identify potential problematic items (≤50% congruent responses). Second, a reflexive thematic analysis was used to uncover causes of incongruency in the problematic items as well as elements of confusion across all items.</p><p><strong>Results: </strong>Thirty-four participants were included. Three items (1, 4, and 6) were identified as being problematic with items 1 and 4 having many incongruent responses. The most common causes of incongruency were related to formulations of items, and seven elements of confusion were uncovered across all items.</p><p><strong>Discussion: </strong>The current study identified potential issues with participants' interpretation of three items. However, as interviews may be prone to the influence of social desirability bias, the interpretation of the results for item 4, where the most frequent non-congruent interpretation of making a fuss was equal to lack of pain validation, is done with caution. Therefore, a revision is suggested with reformulation of item 6 and removal of item 1, which, however, will require validation in future research.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Criteria for Centralized Pain Following Peripheral Nerve Injury: A Systematic Review.","authors":"Floris V Raasveld, Maxime R A Tiems, Benjamin R Johnston, Omar Moussa, Ian L Valerio, David Hao, J Henk Coert, Kyle R Eberlin","doi":"10.1097/AJP.0000000000001326","DOIUrl":"10.1097/AJP.0000000000001326","url":null,"abstract":"<p><strong>Introduction: </strong>Peripheral nerve injuries (PNIs) resulting from trauma or surgery can lead to neuropathic pain and, in some cases progress to centralized pain. This condition significantly affects patients' quality of life and functional abilities. However, diagnostic criteria for centralized pain after PNI remain poorly defined, complicating patient identification and treatment. This systematic review aimede to assess current diagnostic approaches and propose evidence-based criteria for clinical diagnosis.</p><p><strong>Methods: </strong>A systematic search of MEDLINE, Embase, Web of Science, and CENTRAL was conducted for studies assessing diagnostic approaches for centralized pain after PNI. Included studies addressed clinical characteristics, diagnostic tests, or signs of centralized pain after PNI. Exclusion criteria included acute pain studies (<3 mo), pediatric patients, and non-English articles.</p><p><strong>Results: </strong>From 950 citations screened, 28 studies (6189 patients) were included. On the basis of the synthesized evidence, we propose the following diagnostic criteria for centralized pain after PNI: (1) documented peripheral nervous system injury or compression; (2) neuropathic pain persisting for 3 months; (3) hyperalgesia, allodynia, or other forms of hypersensitivity extending beyond the primary zone of injury; (4) associated mood/cognitive disturbances; and (5) limited response to peripheral nerve blocks, defined as <50% pain reduction, if performed.</p><p><strong>Conclusions: </strong>This study proposes a comprehensive, evidence-based diagnostic framework for centralized pain after PNI. The algorithm combines clinical criteria with optional diagnostic testing, providing a practical approach for diagnosis that accounts for variability in access to advanced diagnostic tools. By standardizing the diagnostic process, the framework aims to enhance patient identification and support appropriate treatment selection in clinical practice.</p><p><strong>Level of evidence: </strong>Level III-systematic reviews.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}