The Pain Distress Inventory: Development and Initial Psychometric Properties  Augustine Osman and Francisco X. Barrios University of Northern Iowa  Peter M. Gutierrez Northern Illinois University  Beverly A. Kopper and Adam Butler University of Northern Iowa  Courtney L. Bagge University of Missouri–Columbia A new 26-item self-report measure, the Pain Distress Inventory (PDI), was designed to assess affective distress symptoms related to physical pain. Phases 1 to 3 were designed to construct the PDI using contemporary test development strategies. Studies 1 and 2 were conducted to define and confirm the four-factor oblique structure of the PDI: PDI-Depression, PDI-Anger, PDI-Pain Sensitivity, and PDI-Somatic Anxiety. The internal con- sistency reliability estimates were high for both the PDI total and scale scores. Study 3 examined relationships of the PDI with demographic vari- ables and pain- and psychological-related responses. Scores on the PDI were useful in predicting scores on a pain-interference index and a pain- symptom index. Study 4 was designed to replicate previous findings of reliability and validity. The PDI total and scale scores were useful in differ- entiating between the responses of the clinic and nonclinic study partici- pants. Limitations and potential uses of the PDI are discussed. © 2003 Wiley Periodicals, Inc. J Clin Psychol 59: 767–785, 2003. Keywords: Pain Distress Inventory; psychological responses; reliability; validity Portions of these investigations were presented at the 22nd (2001) annual scientific meeting of the Society of Behavioral Medicine (SBM), Seattle, WA. This work was supported by a Publication Grant from the Graduate College of the University of Northern Iowa. Correspondence concerning this article should be addressed to: Augustine Osman, 334 Baker Hall, University of Northern Iowa, Cedar Falls, IA 50614–0505; e-mail: augustine.osman@uni.edu. JOURNAL OF CLINICAL PSYCHOLOGY, Vol. 59(7), 767–785 (2003) © 2003 Wiley Periodicals, Inc. Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/jclp.10173