Role of Pain-Based Catastrophizing in Pain, Disability, Distress, and Suicidal Ideation

Background: In chronic pain, patients’ coping affects their adaptation. In two studies, we examined the role of pain catastrophizing, a maladaptive coping strategy, in pain, distress, and disability. In Study 2 we compared catastrophizing to pain acceptance and to other coping strategies. Methods: Study 1. Chronic pain patients (N = 428) were assessed four times as to their pain, disability, catastrophizing, and distress (depression and anxiety). Study 2. Patients (N = 165) were assessed as to coping and pain acceptance, pain, related distress, depression, hope, suicidal ideations, perceived burdensomeness, and thwarted belongingness. Results: Study 1. A Structural Equation Modeling (SEM) analysis revealed that Time 1 Pain-based catastrophizing prospectively predicted pain (β =.36, p <.001). Distress prospectively predicted pain related disability (β =.34, p <.001). Study 2. Pain-based catastrophizing predicted sensory pain (β =.22, p =.018), depression (β =.43, p <.001), and suicidal ideation (O.R. = 1.88), which were also predicted by depression and perceived burdensomeness. Distraction predicted sensory pain (β =.21, p =.017, respectively). Activity engagement predicted low levels of depression (β = -.29, p <.001, respectively), and willingness to accept pain predicted low pain-related distress (β = -.16, p =.05). Conclusions: Pain catastro-phizing and pain acceptance constitute risk and resilience factors. Both should be assessed and targeted in pain management.