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Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Breivik, Harald

CiteScore 2017: 0.84

SCImago Journal Rank (SJR) 2017: 0.401
Source Normalized Impact per Paper (SNIP) 2017: 0.452

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Volume 18, Issue 3


Idiographic measurement of depressive thinking: development and preliminary validation of the Sentence Completion Test for Chronic Pain (SCP)

Adina C. Rusu
  • Corresponding author
  • Department of Medical Psychology and Medical Sociology, University of Bochum, Bochum, Germany
  • Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr-University of Bochum, Bochum, Germany
  • Department of Psychology, Royal Holloway University of London, Egham, TW20 0EX, UK
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Dirk Hallner
  • Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr-University of Bochum, Bochum, Germany
  • Other articles by this author:
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Published Online: 2018-06-06 | DOI: https://doi.org/10.1515/sjpain-2018-0059


Background and aims

Depression is a common feature of chronic pain, but there is only limited research into the content and frequency of depressed cognitions in pain patients. This study describes the development of the Sentence Completion Test for Chronic Pain (SCP), an idiographic measure for assessing depressive thinking in chronic pain patients. The sentence completion task requires participants to finish incomplete sentences using their own words to a set of predefined stems that include negative, positive and neutral valenced self-referenced words. In addition, the stems include past, future and world stems, which reflect the theoretical negative triad typical to depression. Complete responses are coded by valence (negative, positive and neutral), pain and health-related content.


A total of 89 participants were included in this study. Forty seven adult out-patients formed the depressed pain group and were compared to a non-clinical control sample of 42 healthy control participants. This study comprised several phases: (1) theory-driven generation of coding rules; (2) the development of a coding manual by a panel of experts (3) comparing reliability of coding by expert raters without the use of the coding manual and with the use of the coding manual; (4) preliminary analyses of the construct validity of the SCP. The internal consistency of the SCP was tested using the Kuder-Richardson coefficient (KR-20). Inter-rater agreement was assessed by intra-class correlations (ICC). The content and construct validity of the SCP was investigated by correlation coefficients between SCP negative completions, the Hospital Anxiety and Depression Scale (HADS) depression scores and the number of symptoms on the Structured Clinical Interview for DSM-IV-TR (SCID).


As predicted for content validity, the number of SCP negative statements was significantly greater in the depressed pain group and this group also produced significantly fewer positive statements, compared to the healthy control group. The number of negative pain completions and negative health completions was significantly greater in the depressed pain group. As expected, in the depressed pain group, the correlation between SCP negatives and the HADS Depression score was r=0.60 and the correlation between SCP negatives and the number of symptoms on the SCID was r=0.56.


The SCP demonstrated good content validity, internal consistency and inter-rater reliability.


Uses for this measure, such as complementing questionnaire measures by an idiographic assessment of depressive thinking and generating hypotheses about key problems within a cognitive-behavioural case-formulation, are suggested.

Keywords: Pain; depression; sentence completion test; reliability; validity; idiographic measure


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About the article

Received: 2018-03-15

Revised: 2018-05-09

Accepted: 2018-05-11

Published Online: 2018-06-06

Published in Print: 2018-07-26

Authors’ statements

Research funding: None declared.

Conflict of interest: The authors declare that they have no competing interests.

Informed consent: All participants provided informed consent.

Ethical approval: The University Ethics Committee and LREC (London Research Ethics Committee) approved this study.

Author contributions

The first author (ACR) contributed to the present study by providing substantial contributions to the study design, data collection, data analyses and interpretation of data. Furthermore, both authors (ACR & DH) were involved in drafting the article and critically amending the first drafts.

Citation Information: Scandinavian Journal of Pain, Volume 18, Issue 3, Pages 491–503, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1515/sjpain-2018-0059.

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©2018 Scandinavian Association for the Study of Pain. Published by Walter de Gruyter GmbH, Berlin/Boston. All rights reserved..Get Permission

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