Section 5 - Using PSPS

PSPS is free to use but permission needs to be sought. Further information is included in Appendix i. [KT1] 

The PSPS has primarily been administered using a self-completion format. This involves either an online survey platform (e.g., Qualtrics) whereby respondents are invited to enter their responses directly online or by self-completion of paper formats of the scale. In both situations, the respondent has not been informed of the final total score.

The PSPS has not yet undergone testing in interview situations where an interviewer reads the items to respondents and records their responses on their behalf. Therefore, the robustness of PSPS in such situations is not yet known.

5.2 Scoring the PSPS descriptive system

Each of the 24 items in PSPS are scored from 0 (Not at all/never) to 4 (Very strongly) and a total score is calculated by summing the 25 individual item scores (Table 3). The minimum score is 0 and the maximum score is 96.

Table 4. Example: Scoring of PSPS- with responses circled (N.B: The responses are circled on the pdf, but highlighted here for accessibility reasons)

Because of the pain…	Not at all/ never	Very little	Moderately	Strongly	Very strongly
I felt defeated by life	0	1	2	3	4
I felt that I had lost my standing in the world	0	1	2	3	4
I felt that life had treated me like a punch bag	0	1	2	3	4
I felt powerless	0	1	2	3	4
I felt that my confidence had been knocked out of me	0	1	2	3	4
I didn’t feel able to deal with things that life threw at me	0	1	2	3	4
I felt that I had sunk to the bottom of the ladder	0	1	2	3	4
I felt completely knocked out of action	0	1	2	3	4
I felt that I was one of life’s losers	0	1	2	3	4
I felt that I had given up	0	1	2	3	4
I felt down and out	0	1	2	3	4
I felt I had lost important battles in life	0	1	2	3	4
I felt that there was no fight left in me	0	1	2	3	4
I feel I was losing my will power	0	1	2	3	4
I didn’t care what happened to me anymore	0	1	2	3	4
I felt defeated	0	1	2	3	4
I felt less like a human being	0	1	2	3	4
In my mind, I gave up	0	1	2	3	4
I felt destroyed as a person	0	1	2	3	4
I felt like I wanted to die	0	1	2	3	4
I felt like I was losing my inner resistance	0	1	2	3	4
I felt like an object	0	1	2	3	4
I felt completely at the mercy of what was happening to me	0	1	2	3	4
I felt humiliated and that I was losing my sense of inner dignity	0	1	2	3	4
Scores	0	1	5x2=10	13x3=39	4x4=16

Total Score= 0 + 1 + 10 + 39 + 16 = 66

5.3 Presenting the results

The PSPS should be reported as the total score, accompanied by the standard deviation (e.g., M= 31.3, SD= 28.0). Furthermore, including the 95% confidence interval and the score range (Minimum = 0, Maximum = 94) can provide insights into the variability of scores within the studied population, whether as a whole or within specific sub-groups.

5.4 Interpreting the results

The total PSPS score among patients with Chronic Pain using the English version of the PSPS tends to fall within a specific range, ranging from 31.3 to 35.53, as presented in Table 3. It is important to note that chronic pain volunteers, who generally have less stringent inclusion criteria, tend to obtain lower scores.

When examining diverse participant groups representing various cultural backgrounds, distinctive patterns become evident. For instance, Hong Kong Chinese Chronic Pain Patients had an average score of 49 (SD 25.9) (21). In contrast, Hong Kong Chinese Chronic Pain Volunteers presented with slightly lower scores, averaging 33.1 (SD 28.9) (21), aligning more closely with the scores observed in UK chronic pain patients. Furthermore, Spanish participants, particularly those diagnosed with fibromyalgia, exhibited an average PSPS score of 33.4 (SD 26.7) (9).

Acute Pain Patients consistently exhibit significantly lower PSPS scores, with an average score of 14.6 (SD 17.4) (7), highlighting the distinct nature of acute pain experiences. In contrast, Acute Pain Volunteers achieve even lower scores, averaging 6.9 (SD 9.2) (7), further emphasizing the substantial difference between acute and chronic pain groups.

Within the Pain-free category, volunteers consistently display minimal pain experiences, recording an average score of 7.2 (SD 9.3) (7). Similarly, Anxiety Controls exhibit slightly elevated scores, with an average of 13.4 (SD 18.9) (7), reflecting the relationship between anxiety and mental defeat.

Lastly, when examining Chronic Pain and Suicide Risk groups, individuals categorized as No/Lower Risk consistently display an average PSPS score of 28.01 (SD 21.40) (11), while those at Higher Risk record notably higher scores, averaging 47.49 (SD 25.71) (11). Additionally, within the US context, No/Lower Risk participants, with or without opioid use, consistently show an average score of 29.1 (SD 26.3), whereas Higher Risk individuals consistently score substantially higher, with an average of 58.8 (SD 28.4) (10).

These findings underscore the importance of considering both cultural and clinical factors when interpreting PSPS scores across different participant groups, as they can significantly influence the outcomes.

Sample size (add in some g-power calculations)

5.5 Dealing with missing data

Instructions: Provide information on how the user can get emergency assistance and system support (e.g., help desk support, production support, etc.). Include the names of the responsible personnel and organization(s), telephone numbers, and email addresses of the staff who serve as points of contact for system support. The following table is provided as an example and may be modified as needed. Also provide instructions for how identified problems with the system are to be reported. Include instructions for security incident handling, as appropriate.

Table 5 - Support Points of Contact

Contact	Organization	Phone	Email	Role	Responsibility
<Contact Name>	<Organization>	<Phone>	<Email>	<Role>	<Responsibility>