Development of a Central Sensitization Inventory short form using data from twenty-three countries
(2026) The Journal of Pain — Vol. 43, p. 106256 (2026)
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- Authors
Neblett, Randy 
Navarrete, Jaime Knezevic, Aleksandar Madi, Mohammad Luciano, Juan V.
- Abstract
- The Central Sensitization Inventory (CSI) assesses central sensitization-related symptoms, but its 25-item length may limit its use in large-scale research or routine clinical practice. Therefore, the aim was to develop a short version of the CSI, using a large international sample of 7862 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. A 7-item solution was ultimately developed (Chi-Square Value = 794.728, df = 20; p-value < 0.001; CFI = 0.96; TLI = 0.96; RMSEA = 0.09, 90%CI [0.09–0.10]; SRMR= 0.05). Internal consistency was adequate for both the CSI-25 (α = 0.93; ω = 0.93) and CSI-7 (α = 0.85; ω = 0.85). Both versions demonstrated strong discriminative validity in identifying subgroups with presumed different levels of central sensitization-related symptoms. As expected, 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 Receiver Operating Characteristic curves showed excellent sensitivity and specificity, particularly in differentiating fibromyalgia from healthy control participants (area under the curve = 0.98; sensitivity of 92% and specificity of 93%). CSI-7 severity levels were empirically derived to aid clinical interpretation. To sum up, the CSI-7 offers an efficient, unidimensional, and internally consistent alternative to the CSI-25 for international use.
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Citations
Neblett, R., Navarrete, J., Knezevic, A., Madi, M., Caumo, W., Wang, L. Y., Ip, W. Y., Culmsee-Holm, L., Nim, C., Kregel, J., Paul van Wilgen, C., Mikkonen, J., Pitance, L., Klute, M., Bilika, P., Bid, D. D., Chiarotto, A., Testa, M., Viti, C., et al. (2026). Development of a Central Sensitization Inventory short form using data from twenty-three countries. The Journal of Pain, 43, 106256. https://doi.org/10.1016/j.jpain.2026.106256 (Original work published 2026)