Dimensionality and Reliability of the Central Sensitization Inventory in a Pooled Multicountry Sample

Antonio I. Cuesta-Vargas*, Randy Neblett, Alessandro Chiarotto, Jeroen Kregel, Jo Nijs, C. Paul van Wilgen, Laurent Pitance, Aleksandar Knezevic, Robert J. Gatchel, Tom G. Mayer, Carlotta Viti, Cristina Roldan-Jiménez, Marco Testa, Wolnei Caumo, Milica Jeremic-Knezevic, Juan V. Luciano

*Corresponding author for this work

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Central sensitization (CS) involves the amplification of neural signaling within the central nervous system, which evokes pain hypersensitivity. The Central Sensitization Inventory (CSI) assesses 25 overlapping health-related symptom dimensions that have been reported to be associated with CS-related disorders. Previous studies have reported satisfactory test-retest reliability and internal consistency, but factor analyses have exhibited conflicting results in different language versions. The purpose of this cross-sectional study was to thoroughly examine the dimensionality and reliability of the CSI, with pooled data from 1,987 individuals, collected in several countries. The principal component analysis suggested that 1 general factor of CS best described the structure. A subsequent confirmatory factor analysis revealed that a bifactor model, which accounted for the covariance among CSI items, with regard to 1 general factor and 4 orthogonal factors, fit the CSI structure better than the unidimensional and the 4-factor models. Additional analyses indicated substantial reliability for the general factor (ie, Cronbach α =.92; ω =.95; and ω hierarchical =.89). Reliability results for the 4 specific factors were considered too low to be used for subscales. The results of this study clearly suggest that only total CSI scores should be used and reported. Perspective: As far as we know, this is the first study that has examined the factor structure and reliability of the CSI in a large multicountry sample. The CSI is currently considered the leading self-report measure of CS-related symptoms worldwide.

Original languageEnglish
Pages (from-to)317-329
Number of pages13
JournalJournal of Pain
Issue number3
Early online date2 Dec 2017
Publication statusPublished - Mar 2018


  • central sensitivity syndrome, chronic pain, psychometrics
  • central sensitization
  • Central Sensitization Inventory
  • multicountry sample


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