Factor structure and psychometric properties of the Chinese version of the 20-Item Pain Anxiety Symptoms Scale (ChPASS-20)


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Context. The Pain Anxiety Symptoms Scale (PASS) was designed to assess painrelated anxiety and fear. Although the scale is a reliable measure with good psychometric properties, its validity among ethnic Chinese has yet to be evaluated. Objectives. This study aimed to translate the English-language version of the 20-item PASS into Chinese (ChPASS-20) and evaluate its factor structure, reliability, and validity. Methods. A total of 223 Chinese patients with chronic musculoskeletal pain attending orthopedic specialist clinics completed the ChPASS-20, the Chronic Pain Grade questionnaire, the Chinese version of the 11-item Tampa Scale of Kinesiophobia, the Hospital Anxiety and Depression Scale, and questions assessing sociodemographic and pain characteristics. Results. Confirmatory factor analyses showed that all the five-factor solutions tested met the minimum acceptable fit criterion. The four ChPASS-20 subscales and the entire scale demonstrated good internal consistency (Cronbach’s as: 0.72e0.92). All ChPASS-20 scales showed significant positive correlations with depression, pain intensity, and disability. Hierarchical multiple regression analyses showed that the ChPASS-20 total score predicted concurrent depression [F(4,159) ¼ 11.97, P < 0.001], pain intensity [F(4,161) ¼ 2.47, P < 0.05], and pain disability [F(4,191) ¼ 5.47, P < 0.001] scores, and the ChPASS-20 Avoidance subscale (standardized beta coefficient ¼ 0.21, P < 0.05) emerged as a significant independent predictor of concurrent pain disability. Conclusion. Our data support the factorial validity, reliability, and construct validity of the ChPASS-20 in a Chinese population. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Original languageEnglish
Pages (from-to)1131–1140
JournalJournal of Pain and Symptom Management
Issue number6
Publication statusPublished - Jun 2012



Wong, W. S., McCracken, L. M., & Fielding, R. (2012). Factor structure and psychometric properties of the Chinese version of the 20-Item Pain Anxiety Symptoms Scale (ChPASS-20). Journal of Pain and Symptom Management, 43(6), 1131–1140.


  • Pain anxiety
  • Chronic pain
  • Chinese
  • Confirmatory factor analysis