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Bath Adolescent Pain Questionnaire (BAPQ)
Availability
Please visit this website for more information about the instrument: Bath Adolescent Pain Questionnaire (BAPQ) and Bath Adolescent Pain Questionnaire for Parents (BAPQ-P)
 
For questions about the BAPQ or BAPQ-P please contact Dr. Lisa Austin at l.austin@bath.ac.uk
Classification
Supplemental: Cerebral Palsy (CP)
Short Description of Instrument
The Bath Adolescent Pain Questionnaire (BAPQ) is a 61-item multidimensional self-report measure that assesses adolescent functioning across seven different domains affected by pain: daily functioning (physical and social), emotional functioning (depression, general anxiety, pain specific anxiety), family functioning, and development. An eighth section provides space for an open-ended narrative response about the impact of pain on the adolescent's life (Eccleston et al., 2005).
 
The BAPQ can be used in research studies and the clinical setting to investigate how chronic pain affects specific aspects of functioning (Eccleston et al., 2005).
 
The Bath Adolescent Pain Questionnaire for Parents (BAPQ-P) is the parent report of the BAPQ to assess parents' perception of how pain impacts their child's life. It was developed as a direct translation of the BAPQ (Eccleston et al., 2005; Eccleston et al., 2007) with the items adapted to incorporate a parental report stem (Eccleston et al., 2007).
Comments/Special Instructions
The BAPQ can be administered to the adolescent, parent/caregiver, or both (Eccleston et al., 2007). The BAPQ and BAPQ-P are available in paper versions. There is also a computerized version of the BAPQ (BAPQ-C). The BAPQ-C is feasible and has increased ease, speed and accuracy of completion compared to the BAPQ (Jordan 2020).
 
CP-specific Pain Category: Pain Interference
 
CP-specific ICF Domain: Activity and Participation (World Health Organization, 2001)
Scoring and Psychometric Properties
Scoring: Each item of the BAPQ and BAPQ-P are rated on a five-point frequency scale in relation to a retrospective time frame of two weeks (Eccleston et al., 2005).
 
The BAPQ subscales measuring daily functioning (social and physical), emotional functioning (depression, general anxiety, and pain specific anxiety), and family functioning are answered using a 5-point frequency scale (0 = never to 4 = always). Higher scores represent more impaired functioning. The developmental functioning subscale uses a 5-point scale ranging from 0 (very behind) to 4 (very ahead) in response to various developmental tasks (Revivo et al., 2019).
 
Psychometric Properties: The BAPQ comprises 61 items across seven different domains of functioning affected by pain: physical functioning, social functioning, general anxiety, pain specific anxiety, depression, family functioning and development. The BAPQ is psychometrically robust. Cronbach's alpha values were >0.79 for all measures. Convergent validity for each subscale was moderate to high between all subscales in adolescents with chronic pain except for comparisons of family and physical functioning, and pain specific anxiety and development. Temporal reliability of the measure has also been demonstrated to be high for social functioning, physical functioning, depression, family functioning, and pain specific anxiety, moderate for general anxiety and development. Comparative validity was undertaken by comparison of all individual subscales with existing validated measures (Spence Children's Anxiety Scale (SCAS), Children's Depression Inventory Short Form (CDI-S), Functional Disability Inventory (FDI), Brief Family Assessment Measure (Brief FAM), Pain Catastrophizing Scale for Children (PCS-C) and Child and Adolescent Social and Adaptive Functioning Scale (CASAFS)) with significant correlations noted for most measures.
 
Parental measures were also found to have high Cronbach's alpha values and good to excellent temporal reliability except for pain specific anxiety. Correlation to adolescent reported measures were significant (Eccleston et al., 2005; Eccleston et al., 2007; Jordan et al., 2020).
 
Overall, the BAPQ is both a reliable and valid assessment of the impact of chronic pain on the lives of adolescents (Eccleston et al., 2005), and the BAPQ-P is a reliable and valid parental report tool for assessing the multidimensional impact of adolescent chronic pain (Eccleston et al., 2007).
Rationale/Justification
Strengths: The BAPQ measures the impact of chronic pain and interference with activities and function across multiple domains for adolescents. It also has a concurrent parent measure. The adolescent self-report measure and the parent report measure can be used together or separately. The measures are well validated.
 
Weaknesses: The BAPQ and the BAPQ-P are not validated for adolescents with disorders like cerebral palsy or cognitive disabilities. The questionnaire's sensitivity to measure change with pain interventions is unknown. Some clinicians may find the length of the assessment infeasible for certain settings. The questions are based on the adolescent's ability to complete tasks, participate, and their perceptions, which may be impacted by factors other than pain such as motor and cognitive abilities.
References
Key References:
Eccleston C, Jordan A, McCracken LM, Sleed M, Connell H, Clinch J. The Bath Adolescent Pain Questionnaire (BAPQ): development and preliminary psychometric evaluation of an instrument to assess the impact of chronic pain on adolescents. Pain. 2005 Nov;118(1-2):263-70.
 
Eccleston C, McCracken LM, Jordan A, Sleed M. Development and preliminary psychometric evaluation of the parent report version of the Bath Adolescent Pain Questionnaire (BAPQ-P): A multidimensional parent report instrument to assess the impact of chronic pain on adolescents. Pain. 2007 Sep;131(1-2):48-56.
 
Additional References:
Center for Pain Research. Bath Adolescent Pain Questionnaire. Retrieved 19August2021: https://www.bath.ac.uk/publications/bath-adolescent-pain-questionnaire-bapq/attachments/bapq-questionnaire.pdf
 
Center for Pain Research. Bath Adolescent Pain Questionnaire for Parents. Retrieved 19August2021: https://www.bath.ac.uk/publications/bath-adolescent-pain-questionnaire-for-parents-bapq-p/attachments/bapq-p-questionnaire.pdf
 
Eccleston C, Wastell S, Crombez G, Jordan A. Adolescent social development and chronic pain. Eur J Pain. 2008 Aug;12(6):765-74.
 
Gagnon C, Amstutz D, Revivo G. Psychometric evaluation of the Bath Adolescent Pain Questionnaire (BAPQ) in a US-based clinical population. J Pain. 2011;12(4 Suppl):P17.
 
Goddard JM, Robinson J, Hiscock R. Routine use of the Bath Adolescent Pain Questionnaire in a paediatric pain clinic. Br J Pain. 2021 May;15(2):155-162.
 
Jordan A, Begen FM, Austin L, Edwards RT, Connell H. A usability and feasibility study of a computerized version of the Bath Adolescent Pain Questionnaire: the BAPQ-C. BMC Pediatr. 2020 Jan 6;20(1):6.
 
Jordan A, Eccleston C, Crombez G. Parental functioning in the context of adolescent chronic pain: a review of previously used measures. J Pediatr Psychol. 2008 Jul;33(6):640-59.
 
Revivo G, Amstutz DK, Gagnon CM, McCormick ZL. Interdisciplinary Pain Management Improves Pain and Function in Pediatric Patients with Chronic Pain Associated with Joint Hypermobility Syndrome. PM R. 2019 Feb;11(2):150-157.
 
World health Organization (2001). International Classification of Functioning, Disability and Health (ICF) Retrieved 19August2021 https://www.who.int/standards/classifications/international-classification-of-functioning-disability-and-health
 
Document last updated August 2022