Table 3. Psychological assessment tools of factors with a negative association with sports injury treatment outcomes.
Category Scale Name and Acronym Factor assessed Length Reliability: internal consistency (Cronbach Alpha) Other useful information
Fear-avoidance response to pain Pain Catastrophizing Scale (PCS)
(Sullivan et al., 1995)
response to pain
13 items 0.87 Items relate to rumination, magnification, and helplessness, associated with reported pain intensity and sensitivity (George and Hirsh, 2009) The PCS has demonstrated good construct and discriminant validity as a measure of catastrophizing, and displayed high test-retest reliability (Sullivan et al., 1995).
Fear-avoidance response to pain Tampa Scale for
Kinesiophobia (TSK) (Huang et al., 2019; Kori et al., 1990) and TSK-11 (Woby et al., 2005))
Fear of
activity and
17 item
11 item
0.76 (TSK) 0.79 (TSK-11) Kvist et al. (2005) adapted for use in ACL patients Can change throughout time, often high in early treatment and seems to persist in patient having trouble with rehabilitation
Fear-avoidance response to pain Fear Avoidance
Questionnaire (FABQ) (Waddell et al., 1993)
Tests association between fear avoidance and work/ activity disability 16 items 0.77-0.88 Used across broad spectrum of orthopedic settings. The FABQ is unique in that it also assesses the effects of pain in the workplace
Fear-avoidance response to pain Fear of Pain Questionnaire (FPQ-III) (McNeil and Rainwater, 1998) Measures fear of pain 30 items 0.92 total scale,
Correlated with pain sensitivity in persons with shoulder pain (George et al., 2008). Validated in healthy controls, along with inpatient and outpatient pain patients receiving treatment for acute or chronic pain.
Psychological Distress Emotional Responses of Athletes to Injury Questionnaire
(ERAIQ) (Smith et al., 1990)
Emotional impact of injury and perceived social support
12 items
Initially developed from clinical interviews and is a psychosocial assessment for injured athletes (Smith et al., 1990). The ERAIQ consists of a list of emotions that respondents rank from 0 to 12, with higher scores reflecting greater emotional disturbance. Used extensively in sports med and with ACL reconstruction. Convergent validity with Short Profile of Mood (LaMott, 1994).
Psychological Distress Surgery Stress Scale (SSS) (Rosenberger et al., 2009) Perceived stress about knee
surgery process

4 items
0.76 Stress was predictive of postoperative pain 1 year postop(Rosenberger et al., 2009)
Psychological Distress Perceived Stress Scale-10 (PSS)
(Cohen et al., 1994)
Measures degree to which
situations are
appraised as stressful

10 items
0.89 total,
The PSS-10 yields a total score along with sub-scores for perceived helplessness and perceived self-efficacy. Items are rated on a 5-point Likert scale.
Psychological Distress State Trait Anxiety Inventory (STAI)
(Spielberger, 2010)
Measures chronic level of anxiety, both state and trait anxiety (scored separately) 40 items 0.89 (STAI-T subscale) Widely used in medical, surgical and psychiatric patients. STAI- Trait (STAI-T) subscale consists of 20 statements that require respondents to rate how they generally feel on a 4-point Likert scale (Bieling et al., 1998). good demonstrated test-retest reliability (Barnes et al., 2002).
Psychological Distress Brief Symptom
Inventory (BSI) (Derogatis and Melisaratos, 1983)
Psychological distress 53 items 0.95 Made up of Global Severity Index and Positive Symptom Distress subscales. Has demonstrated very good test-retest reliability (Derogatis and Melisaratos, 1983).
Depressed Mood Beck Depression
Inventory Fast Screen (BDI-FS) (Steer et al., 1999)
Assess presence and degree of

7 items
0.86 The BDI and subsequent versions have been validated in a variety of medical populations. Has been utilized post-concussion in athletes (Vargas et al., 2015). Assesses symptoms of depression consistent with the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders Fourth Edition (DSM-IV) criteria for Major Depressive Disorder
Depressed Mood Center for
Studies in Depression Scale (CES-D) (Radloff, 1977)
symptoms within
the last week

20 items
0.90 Widely used in general and clinical populations, associated with pain preoperatively(Rosenberger et al., 2009) CES-D does not include an item addressing suicidal ideation or intent
Depressed Mood Hospital Anxiety and Depression Scale HADS (Zigmond and Snaith, 1983) Detects mood

14 items
0.83 for anxiety,
0.82 for
(Bjelland et al., 2002)
Developed for use among patients with concomitant physical health problems. Includes only cognitive and emotional symptoms of depression and anxiety, thereby avoiding mislabeling the physical symptoms of depression, such as fatigue and hypersomnia. Used in non-psychiatric populations. Extensively studied and validated (Bjelland et al., 2002)
Depressed Mood Patient Health
(Kroenke et al., 2001)
Measures how
often athletes
exhibit 9 signs of
depression as
diagnosed by
the DSM-IV

9 items
Brief measure also based on DSM-IV
criteria for Major Depressive Disorder
Depressed Mood Shortened Profile of Mood States
(Shacham, 1983)
Used to assess
temporary mood
states across 6
spectrums of emotion

37 items
0.87 Total mood
(Curran et al., 1995)
Designed to assess transient, distinct
mood states in healthy and medical
patient populations
Depressed Mood Distress and Risk
Assessment Method (DRAM)
(Main et al., 1992)
Measures depressive symptoms among 4
domains: pervasive
affect, physiological equivalents, other
disturbances, and
psychomotor activities

20 items
(depression scale),
(Gabrys and
Peters, 1985)
0.78 (somatic
(Deyo et al., 1989)
Originally validated in patients with
low back pain and designed as a simple screen for clinicians to determine the
degree of patient distress.
Depressed Mood Depression Anxiety Stress Scale (DASS)
(Lovibond and
Lovibond, 1995)
Assessment of
depressed mood,
anxiety, and stress

42 items
0.84-0.97 for
(Parkitny and McAuley, 2010)
Contains separate subscales for
depression, anxiety, and stress.
Depressed Mood Brunel Mood Scale (BRUMS) (Terry
and Lane, 2003)
Measures mood across 6 subscales: anger, confusion, depression, fatigue, tension,
and vigor

24 items
0.76-0.83 for
(Rohlfs et al., 2005)
Among elite athletes, higher BRUMS
depression scores were associated with
a greater number of athletic injuries and more training and competition time
lost post-injury (Galambos et al., 2005).