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Perseverative thinking questionnaire effectively measures repetitive negative thinking in patients with fibromyalgia and strongly correlates with mental health and quality-of-life indicators.
A new validation study positions the perseverative thinking questionnaire (PTQ) as a highly reliable and clinically valuable tool for assessing repetitive negative thinking in patients with fibromyalgia—one of the most complex chronic pain disorders linked to anxiety, depression, and hampered quality of life.
In this cross-sectional study, researchers determined the reliability and validity of the PTQ in those diagnosed according to the 2016 revisions to the 2010/2011 fibromyalgia diagnostic criteria. The study enrolled 57 patients (55 women, 2 men) with a mean age of 45.1 ± 10.0 years. Volunteers completed:
To evaluate stability over time, test–retest reliability was determined after a 15-day interval. Internal consistency was measured via Cronbach’s alpha, and construct validity was checked through Spearman’s correlation analyses. The PTQ illustrated exceptional internal consistency (Cronbach's alpha = 0.996), with a Cronbach’s alpha of 0.996, indicating extremely high reliability. Test–retest reliability was equally strong, with an intraclass correlation coefficient of 0.992, confirming stability over time.
Construct validity analyses showed that higher PTQ scores were strongly connected with greater rumination, higher anxiety and depression scores, and poorer mental health as measured by the SF-12 mental component. A moderate correlation was noted with the SF-12 physical component score. Overall, elevated levels of perseverative thinking were linked to worse psychological, physical, and mental health outcomes.
A ceiling effect was identified, suggesting that the questionnaire may have limited ability to discriminate among those with very high levels of repetitive negative thinking. The findings support PTQ as a valid and highly reliable instrument for assessing perseverative thinking in fibromyalgia patients, making it suitable for both clinical practice and research settings. However, clinicians should interpret high-end scores cautiously due to the observed ceiling effect.
Clinical Rheumatology
Validity and reliability of the perseverative thinking questionnaire in patients with fibromyalgia
Ilke Coskun Benlidayi et al.
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