Publication Date

5-2026

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Abstract

Introduction: School anxiety is common among adolescents with chronic pain and often impacts academic and social functioning. Existing anxiety measures lack specificity for capturing the unique sources and symptoms of school-related anxiety in this population. To address this gap, a bank of new potential measure items (the School Anxiety Inventory for Chronic Pain [SAI-CP]), was developed based on the original School Anxiety Inventory (SAI), qualitative interviews with adolescents with chronic pain, and expert clinician input. The objective of this study was to evaluate the construct validity and internal consistency of the SAI-CP and identify avenues for future measure refinement. Method: Participants were 97 adolescents aged 11-18 (87% White, 62% female, 13.3% minoritized gender identity) seeking treatment in a Midwest pediatric pain clinic or an intensive interdisciplinary pain treatment program. Adolescents completed demographics, PROMIS Anxiety-Short Form, Functional Disability Inventory (FDI), and SAI-CP. The SAI-CP consists of 15 potentially anxiety-provoking school situations, and respondents rate how frequently they experience cognitive, physiological, and behavioral symptoms in these situations from 0 (“never”) to 4 (“always”). Total and symptom subscale scores were calculated, with higher scores indicating greater anxiety. Internal consistency was evaluated using Cronbach’s alpha (α). Pearson’s correlations assessed construct validity. Results: Internal consistency was excellent across three subscales: cognitive (α=0.96), physiological (α=0.96), and behavioral (α=0.96), and total scale (α=0.98). SAI-CP total scores were positively associated with the PROMIS Anxiety total score (r=0.58, p< .001) and FDI (self-report: r=0.34, p< 0.001; parent report: r=0.23, p=0.03). Discussion: Findings suggest that the SAI-CP has very high internal consistency, though this may indicate some redundancy or conceptual overlap in items. Preliminary evidence also supports the construct validity of the SAI-CP. Future work should establish the factor structure of the SAI-CP to improve clinical utility and inform treatment targets for school anxiety in youth with chronic pain.

Disciplines

Pediatrics

Notes

Presented at the Society of Pediatric Psychology (SPPAC) Annual Conference; Las Vegas, NV; April 30-May 2, 2026.

Measuring school anxiety in pediatric chronic pain: Initial investigation of the psychometric properties of the School Anxiety Inventory for Chronic Pain (SAI-CP)

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