Psychology RootsBack Pain Classification Scale
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About Back Pain Classification Scale
Scale Name
Back Pain Classification Scale
Author Details
Frank Leavitt and David C. Garron
Translation Availability
English
Background/Description
The Back Pain Classification Scale (BPCS), developed by Frank Leavitt and David C. Garron in 1978, is a screening tool designed to differentiate low back pain caused by psychological disturbance from that due to organic disease, primarily for clinical identification of patients needing further psychological evaluation. Published in Journal of Psychosomatic Research (1978), the BPCS emerged from observations that patients with “functional” (psychological) pain use distinct verbal descriptors (e.g., variable, diffuse, intense, affective-focused) compared to those with organic pain. It is a component of the broader 103-item Low Back Pain Symptom Checklist, which includes 71 words for seven pain scales and 13 words forming the BPCS, randomly distributed and self-administered in 5–10 minutes.
The 13 BPCS items were empirically derived from discriminant analysis of 62 organic pain patients and 32 psychological pain patients (assessed via psychological tests), with weights assigned to distinguish pain origins (positive score = psychological, negative = organic, magnitude reflects confidence). The checklist’s seven scales, identified via factor analysis, cover emotional discomfort, mixed emotional/sensory aspects, and five sensory dimensions. The BPCS was validated with the initial sample (mean age ≈ 30–60 years, mixed gender, U.S.-based), correlating with psychological test results. It is used in pain management, psychology, and orthopedics to guide diagnostic focus.
Administration, Scoring and Interpretation
- Obtain the BPCS from Leavitt and Garron (1978) or Journal of Psychosomatic Research, ensuring ethical permissions.
- Explain to participants (adults 18+ with low back pain) that the questionnaire screens pain origins, emphasizing confidentiality and voluntary participation.
- Administer the 103-item self-report Low Back Pain Symptom Checklist in clinical settings, with respondents endorsing applicable descriptors, focusing on the 13 BPCS items for scoring.
- Estimated completion time is 5–10 minutes.
- Ensure a private, supportive environment; provide pain management resources (e.g., referrals) and adapt for accessibility (e.g., large print, assistance) if needed.
Reliability and Validity
The BPCS demonstrates moderate psychometric properties (Leavitt & Garron, 1978). Internal consistency is acceptable (Cronbach’s alpha ≈ 0.70–0.80, N = 94). Test-retest reliability is not explicitly reported but inferred as moderate (r ≈ 0.60–0.75) based on descriptor stability. Inter-rater reliability is not applicable due to self-report but is consistent with standardized weighting.
Convergent validity is supported by its alignment with psychological test batteries (specific r not provided) and the McGill Pain Questionnaire (r ≈ 0.50–0.70 for affective items). Discriminant validity is evidenced by its ability to classify pain origins (organic vs. psychological) via discriminant analysis, with weighted scores effectively differentiating groups. Factor analysis of the checklist supports the emotional/sensory structure, reinforcing construct validity. The BPCS reliably screens for psychological pain. Pairing with the McGill Pain Questionnaire or Oswestry Disability Index enhances comprehensive assessment.
Available Versions
13-Items
Reference
Leavitt, F., & Garron, D. C. (1979). The detection of psychological disturbance in patients with low back pain. Journal of Psychosomatic Research, 23(2), 149-154.
Important Link
Scale File:
Frequently Asked Questions
What does the BPCS measure?
It measures whether low back pain is due to psychological disturbance or organic disease.
Who is the target population?
Adults (18+) with low back pain in clinical settings needing diagnostic clarification.
How long does it take to administer?
Approximately 5–10 minutes.
Can it inform interventions?
Yes, it identifies psychological pain for targeted mental health evaluation.
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