Page 31 - JCBP-3-4

Journal of Clinical and
Basic Psychosomatics Somatic symptom disorders and aging

Table 1. Popular scales for the assessment of SSRDs
Name Number of items Key details Source
Pain catastrophizing scale 13 Measures the degree of catastrophizing pain on a 5-point Likert scale from Sullivan 23
(PCS) 0 (not at all) to 4 (all the time). The PCS provides a total score and three
subscales (rumination, magnification, and helplessness).
Patient health 15 Measures the severity of somatic symptoms on a 3-point Likert scale from Kroenke et al. 26
questionnaire-15 (PHQ-15) 0 (not at all) to 2 (bothered a lot). The PHQ-15 provides a total score.
Scale for the assessment of 26 Measures illness behavior on a 4-point Likert scale from 0 (I agree Rief et al. 29
illness behavior (SAIB) completely) to 3 (I disagree completely). The SAIB provides a total score and
five subscales (verification of diagnosis, expression of symptoms, medication,
consequences of illness, and scanning).
Short health illness anxiety 18 Measures health anxiety symptoms on a 4-point Likert scale ranging from 0 Salkovskis et al. 31
inventory (SHAI) (never) to 3 (most of the time). The SHAI provides two subscales (main scale
and negative consequences).
Somatic symptom 12 Measures somatic symptom disorder scales on a 5-point Likert scale ranging Toussaint et al. 35
disorder-B criteria scale from 0 (never) to 4 (very often). The SSD-12 provides a total score and three
(SSD-12) subscales (cognitive, affective, and behavioral).
Somatic symptoms 15 Measures characteristics and symptoms similar to the DSM-5-TR SSRD Herzog et al. 34
experiences questionnaire criteria on a Likert scale ranging from 0 (never) to 5 (always). The SSEQ
(SSEQ) provides a total score and four subscales (health worries, experience of illness,
difficulties with physicians, and consequence of illness).
Whitely index (WI) 14 Measures health anxiety disorder symptoms on a dichotomous scale Pilowsky 28
(yes or no). The WI provides a total score and three subscales (bodily
preoccupation, disease phobia, and disease conviction).
Abbreviations: DSM-5-TR: Diagnostic and statistical manual of mental disorders; SSRD: Somatic symptom and related disorders.

of popular self-report tools and their key features). Some 3 subscales (rumination, magnification, and helplessness).
of the measures have been used in studies with older adults Older participants reported significantly lower levels of
and we will describe the psychometric features of these pain catastrophizing in general, which was largely driven
instruments below. That being said, the use of assessment by their lower scores on the components of rumination
tools not specifically designed for older adults or validated and helplessness, whereas there were no age differences
for use with older adults can lead to potential inaccuracies. on the component of magnification. These results suggest
As such, clinicians and researchers should carefully review some utility for the use of the PCS with older adults.
the psychometric properties of assessment tools that they However, this study did not include any participants
wish to use to ensure that the tools are appropriate for with a formal diagnosis of an SSRD. In a related study,
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the population of interest (in this case, older adults) or Ruscheweyh et al. discovered that pain catastrophizing
to conduct their own validity studies of those measures. in older adults (mean age = 57.9 years) was more highly
In our opinion, development of elder-specific assessment associated with pain intensity compared to younger
tools for SSRDs is a clear priority. adults (mean age = 26.5 years), suggesting that older
adults experience pain catastrophizing more with intense
In the following section, we describe several scales for pain. While this older sample was relatively young, with
SSRDs that have either been psychometrically evaluated in primarily participants in their sixties, the results indicate
older adults or have been used in older adult populations, some preliminary evidence of utility of the PCS with older
with positive or negative results. adults, and highlight the potentially important role of pain
catastrophizing among older adults.
3.1.1. Pain catastrophizing scale (PCS) 23
Petrini and Arendt-Nielsen 24 investigated pain 3.1.2. Patient health questionnaire-15 (PHQ-15) 26
catastrophizing through the PCS in 32 healthy older Van Driel et al. investigated the psychometric properties
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adults (mean age = 74 years) and 34 healthy younger of the PHQ-15 in a population of older adults with
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adults (mean age = 24 years). Participants were measured somatic symptoms. The PHQ-15 is part of a larger sample of
by pressure stimuli and experimental pain testing on a questions that specifically measure the severity of somatic
numerical rating scale. After testing, participants answered symptoms, rather than the similarly named PHQ-9 scale
the PCS which contains a total score and scores on that measures depressive symptoms. The study aimed to

Volume 3 Issue 4 (2025) 25 doi: 10.36922/JCBP025080013