Section 2 - What is PSPS and how was it developed?

The Pain Self Perception Scale (PSPS) consists of 24 items that describe negative thoughts and feelings people may have about themselves due to pain.

All items start with the referent “Because of the pain,” followed by statements such as “…I felt destroyed as a person,” “…I felt that there was no fight left in me,” “…I felt humiliated and that I was losing my sense of inner dignity.”

Respondents are asked to recall a recent episode of intense pain before rating the extent to which each of the items applied to their experience on a 5-point scale (0 to 4), where 0 means “not at all/never” and 4 means “very strongly.” Summing all ratings provides a total score that ranges from 0 to 96, with higher scores indicating higher levels of mental defeat.

The aim of the PSPS is to measure mental defeat as a reaction to pain with a specific focus on self and identity. It requires a person to reflect on a recent episode of pain and is therefore concerned with one’s sense of self rather than a person's projection of the future.

The PSPS was developed through research that was conducted at the Institute of Psychiatry, King’s college London as part of a collaboration between Professor Nicole Tang, Professor Paul Salkovskis with support from Dr Magdi Hanna at King’s College Hospital. The instrument itself combines selected items of two other scales, 11 of which were adapted from the PTSD mental defeat scale (18,19) and the remaining 13 items were adapted from the depression defeat scale (20) to ensure its relevance to the chronic pain population and specificity in associating levels of mental defeat to severe and disabling chronic pain.