Perceived validation and criticism in pain: Development of a new measure in chronic pain

Sérgio A Carvalho, José Pinto-Gouveia, David Gillanders, Paula Castilho

Research output: Contribution to journalArticlepeer-review


Background: Research suggests that the way others react to a pain flare-up impacts on psychological and pain-related symptoms in chronic pain (CP). Experiencing validation from others is associated with less
negative emotions and better functioning. Contrarily, experiencing criticism is linked to greater pain intensity and worse functioning. Nonetheless, studies are limited by an exclusive focus on spouses rather than significant other relationships, the use of proxy constructs (e.g., social support, responsiveness, solicitousness) rather than specific measures of validation and criticism, and a focus on significant others¢ behavior rather than patients' subjective experience. This study examines the psychometric properties of a new measure - Perceived Validation and Criticism in Pain Questionnaire (PVCPQ), and tests its contribution to functional impairment beyond pain intensity, sociodemographic and medical-related variables, positive and negative affect, safeness, and compassion from others.

Methods: Women with CP (N=172), 130 (75.6%) of whom had fibromyalgia, completed an online battery of questionnaires (PVCPQ; numeric pain rating scale; work and social adjustment scale; positive and negative affect schedule; social and pleasure scale; compassionate engagement and action scale). Exploratory factor analysis (EFA), reliability analysis, correlational analysis and hierarchical regression analysis were performed.

Results: EFA showed a 23-item two-factor solution with good psychometric properties. Criticism in pain (but not validation in pain) contributed to functional impairment above and beyond the variance explained
by pain intensity, sociodemographic and medical variables, positive and negative affect, safeness and compassion from others.

Conclusions: These findings suggest that the PVCPQ is a psychometrically valid new measure of perceived validation and criticism in pain that contributes to explaining pain-related functional impairment.
Original languageEnglish
JournalEuropean Journal of Pain
Early online date31 Aug 2020
Publication statusE-pub ahead of print - 31 Aug 2020


  • chronic pain
  • functional impairment
  • compassion
  • validation
  • criticism


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