Validity of the Pain Anxiety Symptoms Scale (PASS): prediction of physicalcapacity variables

Anxious responses to pain may lead to avoidance of behavior expected to pro duce pain. McCracken et al. (1992) developed the Pain Anxiety Symptoms Scal e (PASS) to assess anxiety related specifically to pain. Efforts to validat e the scale, however, have been confined mostly to examining associations b etween the PASS and other self-report instruments. This study tested whethe r PASS scores were related to behavioral performance variables recorded by therapists during a physical capacity evaluation. Participants were 98 male patients with persistent pain referred to two industrial rehabilitation ce nters. PASS scores were correlated negatively with amount of weight lifted and carried, and results of hierarchical regressions showed that PASS score s accounted fur additional variance in these variables when measures of tra it anxiety, depression anti pain severity were controlled. However, we did not replicate the findings of McCracken et al. (1992) that PASS scores acco unted for variance in self-reported disability with trait anxiety, depressi on or pain severity controlled. Results extend the validity of the PASS and are consistent with models of fear of pain: patients with high PASS scores may avoid potentially painful physical exertion to reduce their fear. (C) 2000 International Association for the Study of Pain. Published by Elsevier Science B.V.