The Effect of Pain Catastrophizing on Outcomes: A Developmental Perspective Across Children, Adolescents, and Young Adults With Chronic Pain

Abstract

Pain catastrophizing is one of the most powerful predictors of poor outcomes in youth and adults with pain; however, little is known about differential impacts of pain catastrophizing on outcomes as a function of age. The current study examined the predictive value of pain catastrophizing on pain interference and pain intensity across children, adolescents, and two age groups of young adults with chronic pain. Cross-sectional data are presented from the adult and pediatric Collaborative Health Outcomes Information Registry (CHOIR), including measures of pain catastrophizing, pain intensity, pain interference and emotional distress from 1028 individuals with chronic pain. Results revealed that age moderated the relation between pain catastrophizing and pain interference, with the strength of these effects declining with age. The effect of pain catastrophizing on pain interference was strongest in adolescents and relatively weak in all three other groups. Emotional distress was the strongest predictor of pain interference for children, whereas pain intensity was the strongest predictor for both adult groups. Pain catastrophizing was found to predict pain intensity and, although age was a significant moderator, statistical findings were weak. Developmental considerations and clinical implications regarding the utility of the construct of pain catastrophizing across age groups are discussed.

Predictors of the transition from acute to persistent musculoskeletal pain in children and adolescents: a prospective study

“…Future research can also examine how age and stage of cognitive development may impact associations among catastrophizing and pain outcomes in youth with acute pain. Recent data within a pediatric chronic pain sample found pain catastrophizing was more strongly associated with disability in adolescents compared to younger children [10]. …”

Optimizing Placebo and Minimizing Nocebo to Reduce Pain, Catastrophizing, and Opioid Use: A Review of the Science and an Evidence-Informed Clinical Toolkit

“…Pain is a global health problem with broad negative impacts on physical (Sturgeon, Darnall, Kao, & Mackey, 2015; Sturgeon, Dixon, Darnall, & Mackey, 2015), mental (Bair, Robinson, Katon, & Kroenke, 2003; Feinstein et al, 2017; Ziadni, Sturgeon, & Darnall, 2018), spiritual (Halawa, Al-Diri, McLean, & Darnall, 2015), psychosocial (Karos, Meulders, Goubert, & Vlaeyen, 2018; Karos, Williams, Meulders, & Vlaeyen, 2018; Sturgeon et al, 2016; Ziadni, You, Wilson, & Darnall, 2018), and economic domains (Groenewald, Essner, Wright, Fesinmeyer, & Palermo, 2014; Gustavsson et al, 2012). The 2016 Institute of Medicine report on Relieving Pain in America estimated that roughly one-third of the world population is living with ongoing pain of some type (IOM Committee on Advancing Pain Research, 2011).…”

An overview of a biopsychosocial model of epigenetics and pain catastrophizing

“…In contrast, children typically have less familiarity of being in pain, so they register pain more emotionally. This hypothesis was confirmed by Feinstein et al (2017), who found that for children, emotional-distress predicted PC, but for adults, pain-intensity predicted PC.…”