Dimensions of Coping in Chronic Pain Patients: Factor Analysis and Cross-Validation of the German Version of the Coping Strategies Questionnaire (CSQ-D)

Purpose: The Coping Strategies Questionnaire (CSQ) by Rosenstiel and Keefe (1983) is one of the most widely used measures of coping strategies in pain patients, although its construct and factorial validity is dissatisfying. Verra, Angst, Lehmann, and Aeschlimann (2006) translated the full measure, which assesses eight different coping strategies, into German (CSQ-D). Our aim was to identify stable latent dimensions and present a shorter and more valid version of the CSQ-D. Methods: A principal axes factor analysis (PFA) and a confirmatory factor analysis (CFA) were performed for specification and cross-validation of the new model. Thus, two independent samples of patients with fibromyalgia-like symptoms (n = 321, n = 162) completed questionnaire batteries that included the CSQ-D and measures of fibromyalgia (FM) impact, pain, depression, and anxiety. Results: The most interpretable result appeared to be a six-factor model with an acceptable fit. The first four factors, (1) Catastrophizing (2) Ignoring Pain (3) Diversion, and (4) Reinterpreting Pain, resemble the original scales by Rosenstiel and Keefe (1983). The Praying or Hoping scale split up into distinct (5) Praying and (6) Hoping dimensions. Except Praying, all coping strategies were significantly associated with measures of psychological health outcomes, pain, overall FM impact, or social support. Conclusions: The new short form, called CSQ-DS, is a valid and reliable instrument, composed of 26 items and assessing six coping strategies. Future investigations are recommended to further prove both the external and construct validity of the CSQ-DS.