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BMC Oral Health
Published in: BMC Oral Health 1/2023

Open Access 01-12-2023 | Anxiety | Research

Psychometric evaluation of the Japanese version of the fear of pain questionnaire-III and its association with dental anxiety: a cross-sectional study

Authors: Mika Ogawa, Teppei Sago, Hirokazu Furukawa, Akihiro Saito

Published in: BMC Oral Health | Issue 1/2023

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Abstract

Background

Fear of pain is a significant concern related to chronic pain and its impact on daily functioning. It is also associated with dental anxiety, highlighting its relevance in dental practice. This study aimed to validate the Japanese version of the Fear of Pain Questionnaire-III (FPQ-III) and explore its relationship with dental anxiety.

Methods

400 participants completed the Japanese version of the FPQ-III, with 100 participants re-evaluated after one month. Convergent validity was tested against dental anxiety and pain catastrophizing, while discriminant validity was assessed by examining general anxiety and depression correlations. Confirmatory factor analysis was used to examine the factorial validity of the FPQ-III and a shortened version of the FPQ-III (FPQ-9). Item response theory was applied for each subscale to estimate the discriminative power of each item and draw a test information curve. Structural equation modeling (SEM) was used to investigate the relationship between fear of pain and dental anxiety.

Results

Data from 400 participants (200 women, 44.9 ± 14.5 years) were analyzed. The FPQ-III showed good internal validity, intra-examiner reliability, discriminant validity, and convergent validity. Confirmatory factor analysis results supported a three-factor structure, and the FPQ-9 showed a good fit. Test information curves demonstrated that the FPQ-9 maintained high accuracy over a similarly wide range as the FPQ-III. SEM revealed that fear of minor pain was associated with dental anxiety via fear of medical pain even in individuals without painful medical or dental experiences (indirect effect 0.48 [95% CI: 0.32–0.81]). Fear of severe pain tended to be higher in individuals with chronic pain compared to those without (latent mean values 0 vs. 0.27, p = 0.002) and was also associated with dental anxiety via fear of medical pain in women (indirect effect 0.15 [95% CI: 0.01–0.34]).

Conclusion

The Japanese version of the FPQ-9 demonstrated high reliability and validity, making it a valuable tool in dental clinical and research settings. It provides insights into the fear of pain among individuals with chronic pain and dental anxiety, informing potential intervention strategies.
Literature
1.
Vlaeyen JWS, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000;85(3):317–32.CrossRefPubMed
2.
3.
Cohen SP, Vase L, Hooten WM. Chronic pain: an update on burden, best practices, and new advances. Lancet. 2021;397(10289):2082–97.CrossRefPubMed
4.
Randall CL, McNeil DW, Shaffer JR, Crout RJ, Weyant RJ, Marazita ML. Fear of Pain mediates the association between MC1R genotype and Dental Fear. J Dent Res. 2016;95(10):1132–7.CrossRefPubMedPubMedCentral
5.
McCracken LM, Zayfert C, Gross RT. The Pain anxiety symptoms Scale: development and validation of a scale to measure fear of pain. Pain. 1992;50(1):67–73.CrossRefPubMed
6.
McNeil DW, Rainwater AJ. 3rd. Development of the fear of Pain Questionnaire–III. J Behav Med. 1998;21(4):389–410.CrossRefPubMed
7.
Solé E, Castarlenas E, Sánchez-Rodríguez E, Galán S, de la Vega R, Jensen MP, et al. The reliability and validity of the spanish version of the fear of Pain Questionnaire. J Health Psychol. 2019;24(8):1134–44.CrossRefPubMed
8.
van Wijk AJ, Hoogstraten J. Dutch translation of the fear of Pain Questionnaire: factor structure, reliability and validity. Eur J Pain. 2006;10(6):479–86.CrossRefPubMed
9.
Di Tella M, Ghiggia A, Testa S, Castelli L, Adenzato M. The fear of Pain Questionnaire: factor structure, validity and reliability of the italian translation. PLoS ONE. 2019;14.
10.
Asmundson GJ, Bovell CV, Carleton RN, McWilliams LA. The fear of Pain Questionnaire-Short Form (FPQ-SF): factorial validity and psychometric properties. Pain. 2008;134(1–2):51–8.CrossRefPubMed
11.
Vambheim SM, Lyby PS, Aslaksen PM, Flaten MA, Åsli O, Bjørkedal E, et al. Developing a model for measuring fear of pain in norwegian samples: the fear of Pain Questionnaire Norway. Scand J Pain. 2017;17:425–30.PubMed
12.
McNeil DW, Kennedy SG, Randall CL, Addicks SH, Wright CD, Hursey KG, et al. Fear of Pain Questionnaire-9: brief assessment of pain-related fear and anxiety. Eur J Pain. 2018;22(1):39–48.CrossRefPubMed
13.
McNeil DW, Au AR, Zvolensky MJ, McKee DR, Klineberg IJ, Ho CC. Fear of pain in orofacial pain patients. Pain. 2001;89(2–3):245–52.CrossRefPubMed
14.
Embretson SE. In: Reise SP, editor. Item response theory for psychologists. 371xi, -xi, p. ed. Mahwah, NJ, US: Lawrence Erlbaum Associates Publishers; 2000.
15.
Albaret MC, Muñoz Sastre MT, Cottencin A, Mullet E. The fear of Pain questionnaire: factor structure in samples of young, middle-aged and elderly european people. Eur J Pain. 2004;8(3):273–81.CrossRefPubMed
16.
Mittinty MM, McNeil DW, Brennan DS, Randall CL, Mittinty MN, Jamieson L. Assessment of pain-related fear in individuals with chronic painful conditions. J Pain Res. 2018;11:3071–7.CrossRefPubMedPubMedCentral
17.
Randall CL, Wright CD, Chernus JM, McNeil DW, Feingold E, Crout RJ, et al. A preliminary genome-wide Association Study of Pain-Related fear: implications for Orofacial Pain. Pain Res Manag. 2017;2017:7375468.CrossRefPubMedPubMedCentral
18.
Diotaiuti P, Corrado S, Mancone S, Cavicchiolo E, Chirico A, Siqueira TC, et al. A psychometric evaluation of the italian short version of the fear of Pain Questionnaire-III: psychometric properties, measurement invariance across gender, convergent, and discriminant validity. Front Psychol. 2022;13:1087055.CrossRefPubMed
19.
McNeil D, Randall C. Dental fear and anxiety associated with oral health care: conceptual and clinical issues. 2014. p. 165–92.
20.
Ogawa M, Harano N, Ono K, Shigeyama-Tada Y, Hamasaki T, Watanabe S. Association between sensory processing and dental fear among female undergraduates in Japan. Acta Odontol Scand. 2019;77(7):525–33.CrossRefPubMed
21.
Locker D, Shapiro D, Liddell A. Negative dental experiences and their relationship to dental anxiety. Community Dent Health. 1996;13(2):86–92.PubMed
22.
Ogawa M, Sago T, Lahti S, Taniguchi S. Psychometric Properties of the Japanese Version of the single Dental anxiety question: a cross-sectional online survey. The Open Dentistry Journal. 2020;14(1).
23.
Yamada K, Matsudaira K, Imano H, Kitamura A, Iso H. Influence of work-related psychosocial factors on the prevalence of chronic pain and quality of life in patients with chronic pain. BMJ Open. 2016;6(4):e010356.CrossRefPubMedPubMedCentral
24.
Wang J, Wang X. Structural equation modeling: applications using Mplus. 2nd ed. Hoboken NJ: Wiley; 2020.
25.
Armfield JM, Stewart JF, Spencer AJ. The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear. BMC Oral Health. 2007;7:1.CrossRefPubMedPubMedCentral
26.
Sammut R, Griscti O, Norman IJ. Strategies to improve response rates to web surveys: a literature review. Int J Nurs Stud. 2021;123:104058.CrossRefPubMed
27.
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70.CrossRefPubMed
28.
Hatta H, Higashi A, Yashiro H, Ozasa K, Hayashi K, Kiyota K, et al. A validation of the hospital anxiety and Depression Scale. Jpn JPsychosom Med. 1998;38(5):309–15.
29.
Humphris GM, Morrison T, Lindsay SJ. The Modified Dental anxiety scale: validation and United Kingdom norms. Community Dent Health. 1995;12(3):143–50.PubMed
30.
Yuan S, Freeman R, Lahti S, Lloyd-Williams F, Humphris G. Some psychometric properties of the chinese version of the Modified Dental anxiety scale with cross validation. Health Qual Life Outcomes. 2008;6:22.CrossRefPubMedPubMedCentral
31.
Lahti SM, Tolvanen MM, Humphris G, Freeman R, Rantavuori K, Karlsson L, et al. Association of depression and anxiety with different aspects of dental anxiety in pregnant mothers and their partners. Community Dent Oral Epidemiol. 2020;48(2):137–42.CrossRefPubMed
32.
Furukawa H, Hosaka K. Development of the japanese version of the Modified Dental anxiety scale (MDAS-J): investigation of the reliability and the validity. Japanese J Psychosom Dentistry. 2010;25(1):2–6.
33.
Ogawa M, Sago T, Furukawa H. The reliability and validity of the Japanese Version of the Modified Dental anxiety scale among Dental Outpatients. ScientificWorldJournal. 2020;2020:8734946.CrossRefPubMedPubMedCentral
34.
Sullivan MJL, Bishop S, Pivik J. The Pain Catastrophizing Scale: Development and Validation. Psychol Assess. 1996;7:524–32.CrossRef
35.
Mastsuoka H, Sakano Y. Assessment of Cognitive Aspect of Pain: development, reliability, and validation of japanese Versionof Pain CatastrophizingScale. Jpn J Psychosom Med. 2007;47(2):95–102.
36.
Taber KS. The Use of Cronbach’s alpha when developing and reporting Research Instruments in Science Education. Res Sci Educ. 2018;48(6):1273–96.CrossRef
37.
Shrout PE. Measurement reliability and agreement in psychiatry. Stat Methods Med Res. 1998;7(3):301–17.CrossRefPubMed
38.
Samejima F. Estimation of latent ability using a response pattern of graded scores. Psychometrika. 1969;34(1):1–97.CrossRef
39.
Baker FB. The basics of item response theory. ERIC; 2001.
40.
Cheung GW, Rensvold RB. Evaluating goodness-of-fit indexes for Testing Measurement Invariance. Struct Equation Modeling: Multidisciplinary J. 2002;9(2):233–55.CrossRef
41.
Rizopoulos D. Ltm: an R package for latent variable modelling and item response theory analyses. J Stat Softw. 2006;17(5):1–25.CrossRef
42.
Rosseel Y. lavaan: an R Package for Structural equation modeling. J Stat Softw. 2012;48(2):1–36.CrossRef
Metadata
Title
Psychometric evaluation of the Japanese version of the fear of pain questionnaire-III and its association with dental anxiety: a cross-sectional study
Authors
Mika Ogawa
Teppei Sago
Hirokazu Furukawa
Akihiro Saito
Publication date
01-12-2023
Publisher
BioMed Central
Keyword
Anxiety
Published in
BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-023-03273-8

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