Pain Self-Efficacy Questionnaire (PSEQ)

The Pain Self-Efficacy Questionnaire (PSEQ) is a 10-item questionnaire developed to assess the confidence people with ongoing pain have in performing activities while in pain. The PSEQ is applicable to all persisting pain presentation. It enquires into the level of self-efficacy regarding a range of functions, including household chores, socialising, work, as well as coping with pain without medication.

It takes two minutes to complete and is helpful in assessing the impact that pain is having on a respondent’s life. The scale can be helpful in developing a formulation around psychological factors that influences someone’s response to injury or unpleasant physical sensations. The scale is predictive of functional gains after injury.

Validity and Reliability

The PSEQ has high internal consistency (0.92 Cronbach’s alpha) and test-retest reliability is high of a 3-month period. Validity is reflected in high correlations with measures of pain-related disability, different coping strategies, and another more activity-specific measure of self-efficacy beliefs, the Self-Efficacy Scale. The evidence of the PSEQ’s sensitivity to change provides support for its construct validity.

Vong and colleagues (2009) conducted a validation study using a adult sample (n = 120) where the mean duration of persistent pain was 31 months. The pain locations included the lower back (n=47, 38.3%), neck (n=11, 9.2%), shoulder (n=10, 8.3%), knee (n=8, 6.7%), foot (n=8, 6.7%), wrist (n=3, 2.5%), and other areas (n=14, 11.6%). Among the participants, the mean of total Chinese Pain Self- Efficacy Questionnaire score was 40.1 (SD 11.0). This data can be used to produce percentiles.

Scoring and Interpretation

A raw score is presented with a range from 0 – 60, where high scores indicate greater levels of confidence in dealing with pain. High scores are strongly associated with clinically-significant functional levels and provide a useful gauge for evaluating outcomes in chronic pain patients.

Results are also presented as a percentile derived from a normative sample of chronic pain patients (Vong et al., 2009). Percentiles help contextualise scores in comparison to the typical range of experience of others experiencing pain. For example, a percentile of 50 represents average self-efficacy among chronic pain patients.

Among injured workers, raw scores around 40 (percentile = 50) are associated with return to work and maintenance of functional gains, whilst lower scores (for example a raw score of 30, percentile = 18) tend to predict less sustainable gains (Adams and Williams, 2003).

The scores are helpful in developing a formulation around psychological factors (e.g. beliefs) that influence the respondent’s reaction to injury and pain.


Nicholas, M. K. (2007). The pain self-efficacy questionnaire: Taking pain into account. European Journal of Pain, 11(2), 153-163.


Vong, S. K. S., Cheing, G. L. Y., Chan, C. C. H., Chan, F. & Leung, A. S. L. (2009). Measurement structure of the Pain Self-Efficacy Questionnaire in a sample of Chinese patients with chronic pain. Clinical Rehabilitation 23, 1034-1043.

Adams, J. H., & de C Williams, A. C. (2003). What affects return to work for graduates of a pain management program with chronic upper limb pain?. Journal of occupational rehabilitation, 13(2), 91-106.