Theoretical Perspectives on the Relation Between Catastrophizing and Pain

Abstract

The tendency to "catastrophize" during painful stimulation contributes to more intense pain experience and increased emotional distress. Catastrophizing has been broadly conceived as an exaggerated negative "mental set" brought to bear during painful experiences. Although findings have been consistent in showing a relation between catastrophizing and pain, research in this area has proceeded in the relative absence of a guiding theoretical framework. This article reviews the literature on the relation between catastrophizing and pain and examines the relative strengths and limitations of different theoretical models that could be advanced to account for the pattern of available findings. The article evaluates the explanatory power of a schema activation model, an appraisal model, an attention model, and a communal coping model of pain perception. It is suggested that catastrophizing might best be viewed from the perspective of hierarchical levels of analysis, where social factors and social goals may play a role in the development and maintenance of catastrophizing, whereas appraisal-related processes may point to the mechanisms that link catastrophizing to pain experience. Directions for future research are suggested.

Gabapentin reduces preoperative anxiety and pain catastrophizing in highly anxious patients prior to major surgery: a blinded randomized placebo-controlled trial

“…34 Thus, the tendency to catastrophize about the impending surgical experience and anticipated pain increases distress and may contribute to a more intense pain experience. 18 As anxiety increases preoperatively, patient preoperative quality of life suffers inversely. 21 Recent studies have revealed that pre-surgical pain catastrophizing is a unique predictor of immediate post-surgical pain and the severity of pain up to six weeks after surgery.…”

“…Pain catastrophizing is associated with a multitude of pain-related outcomes, including pain severity, decreased pain tolerance, increased post-surgical pain, increased analgesic consumption, and somatization. [15][16][17][18] High levels of pain-related anxiety has also been associated with greater pain severity, disability, and lower quality of life. 19 Patient factors, such as female sex and younger age, are correlated with heightened fear-based states that lead to increased perioperative pain and anxiety.…”

Impact of male partner responses on sexual function in women with vulvodynia and their partners: A dyadic daily experience study.

“…The communal coping model (CCM) of pain suggests that expressions of pain to significant others may serve to evoke particular responses, such as assistance (Sullivan et al, 2001). Further, operant learning theory asserts that partners can directly influence a person's pain experience and associated disability (Fordyce, 1976).…”

The prognostic value of catastrophizing for predicting the clinical evolution of low back pain patients: a study in routine clinical practice within the Spanish National Health Service

“…[1][2][3][4][5][6][7][8][9] FAB refer to the fear-induced avoidance of movements or activities which are expected to be painful, whereas catastrophizing is defined as an exaggerated negative mental state related to an actual or anticipated painful experience. [1][2][3][4][5][6][7][8][9] In the Spanish cultural environment, FAB have shown to have an either negligible or nonexistent influence on LBP among elderly populations and among acute, subacute and chronic LBP patients treated in routine practice, [10][11][12][13] whereas catastrophizing correlates with disability and explains approximately one fourth of its variance, 13,14 suggesting that it may have an influence on the prognosis of LBP patients.…”