Fear of Pain, Pain Catastrophizing, and Acute Pain Perception: Relative Prediction and Timing of Assessment

Abstract

Pain-related fear and catastrophizing are important variables of consideration in an individual's pain experience. Methodological limitations of previous studies limit strong conclusions regarding these relationships. In this follow-up study, we examined the relationships between fear of pain, pain catastrophizing, and experimental pain perception. One hundred healthy volunteers completed the Fear of Pain Questionnaire (FPQ-III), Pain Catastrophizing Scale (PCS), and Coping Strategies Questionnaire-Catastrophizing scale (CSQ-CAT) before undergoing the cold pressor test (CPT). The CSQ-CAT and PCS were completed again following the CPT, with participants instructed to complete these measures based on their experience during the procedure. Measures of pain threshold, tolerance, and intensity were collected and served as dependent variables in separate regression models. Sex, pain catastrophizing, and pain-related fear were included as predictor variables. Results of regression analyses indicated that after controlling for sex, pain-related fear was a consistently stronger predictor of pain in comparison to catastrophizing. These results were consistent when separate measures (CSQ-CAT vs. PCS) and time points (pre-task vs. "in-vivo") of catastrophizing were used. These findings largely corroborate those from our previous study and are suggestive of the absolute and relative importance of pain-related fear in the experimental pain experience.Perspective-Although pain-related fear has received less attention in the experimental literature than pain catastrophizing, results of the current study are consistent with clinical reports highlighting this variable as an important aspect of the experience of pain.

Pain-Related Rumination, But Not Magnification or Helplessness, Mediates Race and Sex Differences in Experimental Pain

“…The PCS has been shown to tap into a singular construct, which is characterized by three dimensions: rumination, magnification, and helplessness 55 . Consistent with previous studies, we used a modified version of the PCS measuring situation-specific (i.e., in-vivo) pain catastrophizing 15,29,32 . Immediately following the cold presser task, participants rated how frequently they experienced catastrophic cognitions (e.g., "I can't stop thinking about the pain,") during the pain task using a 5-point scale ranging from 0 (not at all) to 4 (all the time) 72 .…”

Catastrophizing—a prognostic factor for outcome in patients with low back pain: a systematic review

“…We 25 -5 -focused on cohort studies that included at least 300 subjects with a minimal follow-up of three 1 months because of a concern about sample size. Assuming a baseline risk of 20% for 2 chronicity following a bout of acute LBP [1], a sample size of 316 patients in a two-level 3 exposure study (catastrophizing high vs. catastrophizing low) would generate a relative risk 4 (RR) of 1.75 for the outcome recovery at three months [14]. 5 However, inclusion of cohorts of more than 300 patients would have included almost 6 exclusively cohorts with patients suffering from chronic LBP.…”

In Vivo Praying and Catastrophizing Mediate the Race Differences in Experimental Pain Sensitivity

“…Participants rated how often they use each strategy to cope with pain from 0 (never do that) to 6 (always do that). Consistent with previous studies, the instructions for the CSQ-R were revised to measure situation-specific coping, such that participants were asked to rate how often they used each strategy to cope with the pain they experienced during the CPT 7,12,20,24 . The CSQ-R has a more refined factor structure than the original CSQ, with subscale reliability ranging from 0.72 to 0.86 35,36 .…”