• J A Verbunt, A Nijhuis, M Vikström, A Stevens, N Haga, J de Jong, and M Goossens.
• Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, The Netherlands; Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands.
• Eur J Pain. 2015 May 1;19(5):695-705.

BackgroundCognitive-behavioural models of chronic pain predict that dysfunctional assumptions about harmfulness of activities may maintain pain-related fear and disability. To assess perceived harmfulness in adolescents, the Photograph Series of Daily Activities for youth (PHODA-youth) was developed. Information concerning its methodological quality is currently lacking.ObjectiveTo investigate psychometric characteristics (factor structure, test-retest reliability, construct validity) and feasibility of the PHODA-youth in adolescents with chronic musculoskeletal pain.Study DesignTest-retest design.Study PopulationAdolescents aged 13-21 years with chronic nonspecific musculoskeletal pain.MethodsParticipants filled in an electronic version of the PHODA-youth including 89 items twice with a 4-week interval. The instrument's factor structure was determined by a factor analysis. Construct validity was studied with criterion variables: catastrophizing (Pain Catastrophizing Scale for Children), pain intensity (visual analogue scale), depression (Children's Depression Inventory) and pain-related disability (Functional Disability Inventory) using regression analysis. Test-retest reliability was evaluated based on the Pearson correlation coefficient. Feasibility was studied with self-constructed questions.ResultsSeventy-one adolescents participated. Results show a three-factor structure for the PHODA-youth including 51 items with subscales labelled as: 'activities of daily life', 'intensive physical activities' and 'social activities'. Total and subscale scores showed a high internal consistency. Its test-retest reliability was good (r = 0.94) and its construct validity is supported by the finding that both catastrophizing (β = 0.25; p = 0.02) and disability (β = 0.71; p < 0.001) were uniquely related to the PHODA-youth. In addition, feasibility appeared adequate.ConclusionThe findings support the PHODA-youth as a valid and reliable measure of the perceived harmfulness of activities in adolescents with musculoskeletal pain.© 2014 European Pain Federation - EFIC®

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