251: Development and Validation of the Central Sensitization Inventory Short Form: A Multicountry Study

Topic: Clinical Science
Subtopic: Non-specific to any diagnosis, Psychology, Developing methodology/technology, Assessment and Measurement of Pain/Nociception

Background and Aims: The Central Sensitization Inventory (CSI) is a 25-items instrument designed to measure symptoms related to central sensitization. It was developed from a comprehensive literature review of symptom dimensions and related factors common to central sensititivity-related conditions (e.g., widespread pain, cognitive slowing, sleep disturbance, etc.). The CSI has been adapted and tested in multiple languages. The aim of this study was to develop a brief version of the CSI-25 with the fewest possible items, while still capturing the most widely accepted central sensitivity symptoms. Rasch analysis of CSI-25 data from a large multicultural sample was used to develop the new short form.

Methods: We developed a short version of the CSI-25, using a large, international, and heterogeneous sample of 7,862 participants across 23 countries. A multi-step Rasch analysis was applied to the 25-item version of the CSI using a training-validation paradigm to identify the subset of items that best fit a unidimensional model. Then, an expert committee reviewed the face-content validity of each item. This study is reported in accordance with the COSMIN guidelines for reporting studies on the measurement properties of PROMs. Patients and the public were not involved in the design or conduct of this research study.

Results: A 7-item solution was developed (x2 = 794.728, df = 20; p < 0.001; CFI = 0.96; TLI = 0.96; RMSEA = 0.09; SRMR= 0.05). Internal consistency was adequate for both the CSI-25 (α = 0.93) and CSI-7 (α = 0.85). Both versions demonstrated strong discriminative validity in identifying subgroups with presumed different levels of central sensitization. CSI-25 and CSI-7 scores increased progressively from healthy control participants (who scored lowest) to single-site non-spinal chronic pain, chronic spinal pain, multi-site chronic pain, and fibromyalgia (who scored highest). CSI-7 ROC curves showed excellent sensitivity-specificity (e.g. fibromyalgia vs healthy control; Sensitivity= 92% and specificity= 93%).

Conclusions: The present study demonstrated the CSI-7 to be a good alternative to the CSI-25, especially in clinical settings where time constraints limit the use of longer instruments. It was found to be psychometrically sound, with strong internal consistency and discriminative validity that was comparable to the CSI-25. The shorter format of the CSI-7 might enhance patient compliance and feasibility in large-scale screening and patient stratification processes and could perhaps be more easily integrated into multimodal assessment batteries than the longer CSI-25 version. In summary, the CSI-7 offers an efficient, unidimensional, and internally consistent alternative to the CSI-25 for international use.

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Presenting Author: Juan V. Luciano
Submitting Author: Juan Luciano

Senior Author: Juan V. Luciano

IASP 2026 Global Year theme of Neuropathic Pain: No

• Jaime Navarrete: PhD - CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
• Randy Neblett: MA, LPC, BCB - PRIDE Research Foundation, Dallas, TX, USA.