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It was hypothesized that internal consistency would be acceptable, that test-retest reliability would be good, and that CSQ-Revised maladaptive coping strategies would be statistically significantly and positively related to poor outcomes of pain intensity, disability and depression. The aim of the present study was to describe the cultural adaptation of the CSQ-Revised and its validation in a large sample of subjects with chronic pain to enable its use in Italian-speaking subjects in Italy and abroad. However, the CSQ-Revised version has yet to be adapted and psychometrically analyzed in Italian subjects, thus limiting the opportunities for researchers and clinicians to share the validated outcomes of chronic pain patients.

Translations of the CSQ have been validated and allow comparisons among different populations and countries ( 9– 11). A subsequent confirmatory factor analysis (CFA) established the good fit of this model (ie, the CSQ-Revised) ( 8). In 1996, an exploratory factor analysis of a large sample of subjects with chronic pain suggested a six-factor solution that was relatively supportive of the original scales, and showed satisfactory reliability and construct validity ( 7). Although it had good reliability and validity, it showed an unstable structure ( 3– 5) that has been hypothesized to be mainly due to difficulties in measuring differences in cognition between different clinical settings, disorders and pain problems ( 6). The Coping Strategies Questionnaire (CSQ) was developed in 1983 by Rosenstiel and Keefe ( 3) using a pool of items reflecting coping strategies frequently reported by patients and deemed to be important by researchers and clinicians involved in the management of pain. Therefore, it appears to be crucial to identify the cognitive factors that may promote adaptive functioning despite the presence of pain, such as coping strategies (ie, the use of cognitive and behavioural techniques to manage stressful events), because these can help to explain differences in adjustment among subjects experiencing chronic pain, determine cognitive strengths and weaknesses, identify treatment targets and predict outcomes ( 2). However, not everyone experiencing chronic pain is physically disabled or invariably depressed many continue their work and social activities, and rarely seek medical assistance or the help of a significant other ( 1). Chronic pain is characterised by physical dysfunction, disability and mood alterations ( 1).

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