Objective: To determine the factor structure of the Coping Strategies Questionnaire (CSQ)¹ in chronic low back pain patients (CLBP) presenting for physiotherapy.

Subjects: CLBP patients presenting for their first assessment at an outpatient physiotherapy department were used (N = 105; 60% male; M age = 41 yrs; SD ± 10).

Design: A factor analysis, using varimax rotation, was performed on patients’ responses to the CSQ. Factors emerging with eigenvalues of ≥1 were considered. A coping strategy was included in a factor if it correlated with the factor at a level greater than 0.6.

Results: Three factors accounted for 70% of the variance in questionnaire responses. Factor 1, labeled Adaptive Coping, accounted for 35% of the variance and comprised the subscales for reinterpreting pain sensations, ignoring pain sensations, and coping self-statements. Factor 2, labeled Maladaptive Coping, accounted for 23% of the variance and comprised the subscales for diverting attention, catastrophizing, praying or hoping, and behavioural coping styles. The final factor, labeled Efficacy of Pain Management, accounted for 12% of the variance and comprised the two single-item scales. Adaptive Coping was positively correlated with Maladaptive Coping (r = 0.37, P < 0.01). Efficacy of Pain Management was positively correlated with Adaptive Coping (r = 0.28, P < 0.01). A non-significant negative correlation was found between Maladaptive Coping and Efficacy of Pain Management (r = −0.03, P > 0.05).

Conclusion: Three underlying factors, labelled Adaptive Coping, Maladaptive Coping, and Efficacy of Pain Management accounted for 70% of the variance in questionnaire responses.

Objective: To determine the extent to which coping strategies mediate chronic low back pain (CLBP) disability in patients presenting for physiotherapy.

Subjects: CLBP patients presenting for their first assessment at an outpatient physiotherapy department were used (N = 90; 60% male; M age = 41 yrs; SD ± 10).

Design: The mediating role of coping strategies was investigated after controlling for the influence of recorded demographics, healthcare variables and pain. Hierarchical multiple regression was employed with disability¹ as the dependent variable. Independent variables were entered in three separate steps. Demographics (sex, age and socioeconomic status) were entered in Step one. Healthcare and Pain variables (leg pain, previous surgery, history of back pain and current pain intensity [VAS]) were entered in Step two. Three coping dimensions (Adaptive Coping, Maladaptive Coping and Efficacy of Pain Management), derived from a factor analysis of the Coping Strategies Questionnaire², were entered in the final Step.

Results: Demographics accounted for 14% of the variance in disability [F (3, 86) = 4.81, P =. 004]. Healthcare and Pain variables accounted for an additional 17% of the variance [F (4, 82) = 5.11, P =. 001]. The three coping dimensions accounted for a further 6% of the variance [F (3, 79) = 2.71, P =. 05]. The model accounted for 38% of the variance in disability [F (10, 79) = 4.81, P =. 000].

Conclusion: Coping did mediate levels of CLBP disability. Moreover, disability is influenced more by Adaptive (Standardised β = −. 26, P =. 02) and Maladaptive (Standardised β =. 27, P =. 02) coping strategies than Efficacy of Pain Management (Standardised β =. 07, P > . 05).

Objective: To assess the psychometric properties of the Tampa Scale for Kinesiophobia (TSK)¹.

Subjects: Eighty-four chronic low back pain (CLBP) patients presenting for their first assessment at an outpatient physiotherapy department were used (57% female; M age = 45 yrs; SD ± 10 yrs).

Design: Eighty-four patients completed the TSK. Internal consistency, item-total correlations, distribution of scores on each item, three-day test-retest reliability and responsiveness were then calculated. To determine responsiveness, patients were categorised into two groups, namely meaningful change in pain-related fear (Group 1) and non-meaningful change in pain-related fear (Group 2). Patients were categorised based on their response to a thirteen-point global rating scale (GRS). Standardised Response Means (SRMs)² were computed for each group.

Results: Internal consistency was excellent (Cronbach α = 0.82). With the exception of items 8 and 16 all item-total correlations exceeded the level of 0.20. Scores were normally distributed for most items, however, items 4, 12 and 14 were positively skewed (Z-scores > 1.96). Test-retest coefficients were high (ICC = 0.91). SRMs were −0.96 and −0.44 for Groups 1 and 2, respectively, thus indicating good discriminatory power. An adapted version of the TSK (MTSK-12), constructed from the twelve most psychometrically robust items, had comparable reliability and validity (Cronbach α = 0.82; ICC = 0.91; SRM [Group 1] = 0.89; SRM [Group 2] = 0.39).

Conclusion: Overall the TSK has excellent psychometric properties. The MTSK-12 is a valid and reliable measure of pain-related fear and warrants further investigation.