Development of the Pain Responses Scale: A measure informed by the BIS-BAS model of pain

Background The behavioural inhibition system and activation system (BIS-BAS) model of pain focusses on two clusters of responses to pain-escape/avoidance (BIS) and approach (BAS) behaviours. While the BIS-BAS model emphasizes active responses to pain, deactivation responses such as despondence and relaxation are also common. This study sought to develop self-report scales assessing cognitive, behavioural intentions and affective responses to pain consistent with this extended BIS-BAS framework. We also sought to develop short-forms of the emerging scales. Methods Confirmatory factor analysis was performed to derive scales from a large item pool administered to a community sample with heterogeneous chronic pain (N = 476). Results The items resulted in 16 scales assessing Thoughts, Affective responses, Behavioural Intentions and Valence-Associated Thoughts, which loaded on to the four theorized types of pain responses-Escape, Approach, Despondence and Relaxation-with the four emerging short-form scales assessing these overarching factors. The internal consistency reliabilities of the long-forms generally ranged from good to excellent (alpha s >= 0.83), with the exception of the Relaxation-Behavioural Intentions scale (alpha = 0.64). The four short-forms demonstrated at least adequate internal consistency reliability (alpha s >= 0.79). An initial test of the construct validity of the scales in relation to pain-related outcomes is also reported. Conclusions We anticipate that the Pain Responses Scale (PRS) developed from this research will be useful for assessing mechanisms targeted by many psychosocial pain treatments and will provide a nuanced understanding of the shared versus specific nature of these mechanisms. Significance The Pain Responses Scale emerging from this research assesses four theorized, overarching responses to pain: Escape, Approach, Giving Up and Relaxation. This measure will afford the capacity to test a reconceptualized BIS-BAS model of pain and inform treatments that are adapted based on this framework.