Pain catastrophizing: rumination is a discriminating factor among individuals with different pain characteristic

Abstract

The objective of this study was to compare the scores of the Helplessness, Magnification, Rumination, and Catastrophizing factors of the Pain Catastrophizing Scale (PCS) between samples with different pain characteristics. The psychometric properties of the PCS were evaluated in 1,151 Brazilian adults (78.9% female; 38.6 (SD = 10.8) years): 335 had no pain, 390 had been in pain for less than 3 months, 250 had been in recurring pain for more than 3 months, and 176 had been in continuous pain for more than 3 months. Confirmatory factor analysis (CFA) was conducted to verify the fit of the PCS models. Convergent validity and reliability were evaluated. Multi-group analysis was used to estimate the invariance of the factorial model. The global score for the PCS factors was obtained using the regression weight matrix for estimating factor scores from CFA. Analysis of variance was used to compare scores between samples. After excluding three items, the tri-factorial model showed adequate fit. The model parameters were invariant (Δχ 2 (λ,i,β,Res) ; p≥0.05). Individuals experiencing pain showed higher scores for catastrophic thoughts. Individuals with pain for less than 3 months had the highest scores for Rumination (p < 0.001). The PCS showed valid, reliable, and invariant results for the sample of Brazilian adults in no pain or with different pain conditions. The PCS adequately discriminated individuals in pain from those without pain. Among those in pain, Rumination was the only discriminating factor.

Activity Patterns and Functioning. A Contextual–Functional Approach to Pain Catastrophizing in Women with Fibromyalgia

“…When the goal of alleviating or controlling pain is a requirement to achieve other vital goals, it ends up prevailing and gaining importance in the set of individual goals, promoting avoidance behaviors [ 29 ]. Furthermore, rumination constitutes the most analyzed factor within pain catastrophizing and some studies indicate that it has the greatest predictive power regarding the chronification of pain [ 42 , 43 , 56 , 57 ] and acute postsurgical pain [ 58 ].…”

“…Previous literature in this regard is not excessively abundant, and the results found are not always consistent, so further research is necessary [ 41 ]. However, the results found indicate that rumination and helplessness seem to be linked to a wide diversity of health outcomes in chronic pain, while magnification seems to be more specifically related to worse mental health [ 41 , 42 , 43 , 44 ]. In this context, the Fibromyalgia impact measure (FIQR), used as an outcome in the present study, includes both indicators of interference of the disease and symptoms as pain, quality of sleep, and emotional symptoms, among others [ 45 ].…”

Catastrophic thinking and functional disability in Primary Health Care chronic pain patients

“…The maintenance of an optimistic and resilient attitude improves the adaptation to CP and reduces hypersensitivity 30 . Studies 20,31,32 show that the adjunct non-pharmacological approach, through educational actions directed to self-management of pain, contribute to the more resilient attitude towards CP and the reduction of drug use. This way, the progress of recovery is facilitated and the levels of catastrophizing and disability decrease.…”