Objectives: Nociplastic pain is implicated in many chronic pain conditions, yet it has been defined primarily by the absence of structural causes—a diagnosis by exclusion. No validated nociplastic pain questionnaire exists. This study examined hypothesized pain-specific features of nociplastic pain and developed a brief self-report instrument, the Nociplastic Questionnaire (NociQ). Methods: We generated items based on literature review and input from experts and individuals with lived experience. We administered the items and measures of other pain-related constructs (pain intensity/interference, catastrophizing, kinesiophobia, and perceived stress) to 888 participants with diverse chronic pain conditions. Results: Factor analyses supported four dimensions captured by internally consistent 4-item subscales (αs ≥0.74): 1) location variability, 2) exacerbation by thoughts and emotions, 3) widespreadness, and 4) allodynia. The NociQ total score adequately discriminated presumed nociplastic and non-nociplastic conditions (AUCs 0.73-0.75). Participants who had widespread pain or reported more presumed nociplastic conditions scored higher on all scales ( p s <.001, d s=0.35–1.37). NociQ scales demonstrated small-to-moderate correlations with measures of theoretically distinct constructs ( r s=0.10–0.44), supporting discriminant validity, and explained additional variance in pain intensity beyond those measures (Δ R²s =.02-.07; p s <.05), supporting incremental validity. Discussion: Results indicate four nociplastic pain characteristics, including two, location variability and exacerbation by thoughts and emotions, psychometrically validated here for the first time. The 16-item NociQ demonstrates promising reliability and validity as a brief questionnaire of nociplastic pain. Future research should examine its clinical utility, such as in matching patients to pain mechanism-targeted treatments.
Objectives: This study investigated the clinical utility of the Pediatric Evaluation of Disability Inventory – Computerized Adaptive Test (PEDI-CAT), adapted as a self-report measure of disability among youth with chronic pain. Methods: Participants (N=199) completed the PEDI-CAT Daily Activities and Mobility subtests and biopsychosocial questionnaires at intensive interdisciplinary pain treatment (IIPT) admission and discharge. First, we conducted cognitive interviews (N=5) to understand participants’ interpretation of the items when administered via self-report. Then, we evaluated 1) responsiveness of the PEDI-CAT subtests, 2) convergent validity of PEDI-CAT admission T-scores, and 3) factors associated with average (i.e., recovered) PEDI-CAT T-scores at discharge. Results: Cognitive interviews supported using the PEDI-CAT as a self-reported outcome in youth with chronic pain. PEDI-CAT Daily Activities T-scores significantly correlated with all outcomes at admission except pain intensity and body coordination. Mobility T-scores significantly correlated with outcomes of functioning and risk for poor prognosis on the PPST but did not correlate with psychological outcomes or pain intensity. Daily Activities and Mobility T-scores significantly improved after IIPT ( P <0.001). Mean Daily Activities T-scores were average at admission and discharge. Most participants reported below average Mobility T-scores at admission and discharge. Multivariable logistic regression showed less anxiety, younger age, higher admission scores, and shorter length of stay increased odds of reporting average (i.e., recovered) Mobility at discharge. Discussion: The PEDI-CAT adapted for self-report measured meaningful improvements in disability in youth with chronic pain undergoing IIPT. Further evaluation of the PEDI-CAT psychometrics in youth with chronic pain is warranted.
Objectives: Pain acceptance is a psychological mechanism that may play a role in opioid use and misuse among adults living with chronic pain. This study aims to synthesize the available evidence exploring the association between pain acceptance and opioid use outcomes in adults with chronic pain. Methods: A systematic review was conducted in October 2025 by searching PubMed, PsycInfo, and Web of Science using predefined search terms and systematic review criteria to identify the published literature that explores association between pain acceptance and prescription opioid use or misuse. Results: A total of 14 studies were identified. Most studies indicated that pain acceptance may be negatively associated with opioid use (i.e., those with greater pain acceptance are less likely to report opioid use and misuse). This association was primarily supported through correlational research, with some preliminary intervention effects reported as well. Discussion: This systematic review highlights that pain acceptance may be a protective factor for attenuating opioid use and misuse among adults with chronic pain. Further clinical research is needed to explore whether pain acceptance can be leveraged to decrease opioid use and misuse.
