The concurrent validity of brief screening questions for anxiety, depression, social isolation, catastrophization, and fear of movement in people with low back pain

Peter Kent, Saeida Mirkhil, Jennifer Lyn Keating, Rachelle Buchbinder, Claus Manniche, Hanne B Albert

Research output: Contribution to journalArticleResearchpeer-review

22 Citations (Scopus)


OBJECTIVES: (i) to test the concurrent validity of brief screening questions for five psychosocial constructs (anxiety, depression, social isolation, catastrophization and fear of movement), and (ii) to translate into Danish and validate those screening questions. METHODS: Data were collected from five cross-sectional samples (total n=1105) of people seeking care for low back pain in Australian primary care settings and a Danish secondary care hospital. The responses to English and Danish-translated versions of one- or two-item screening questions were compared with those of validated full-length questionnaires. RESULTS: Compared to anxiety, depression and social isolation scores from full-length questionnaires, screening questionnaire responses demonstrated: a correlation of 0.62 to 0.83, overall accuracy 78 to 91 , sensitivity 70 to 82 , specificity 75 to 95 , positive likelihood ratios 3.3 to 13.9, and negative likelihood ratios 0.21 to 0.33. For catastrophization and fear of movement, results demonstrated: correlation 0.89 to 0.95, overall accuracy 88 to 93 , sensitivity 78 to 88 , specificity 91 to 96 , positive likelihood ratios 9.5 to 20.8, and negative likelihood ratios 0.13 to 0.23. DISCUSSION: The concurrent validity of these screening questions was comparable to, or better than, alternate questions previously reported, and stable across age, gender, pain intensity, pain duration, and counties. Based on the observed likelihood ratios, all of the screening questions provided moderate or strong evidence to rule in or out an extreme score on each psychosocial construct.Given the ease of administration of these brief screening questions, their prognostic and treatment implications should be investigated.
Original languageEnglish
Pages (from-to)479 - 489
Number of pages11
JournalThe Clinical Journal of Pain
Issue number6
Publication statusPublished - 2014

Cite this