Background & Aims

Pain catastrophizing (PC), defined as rumination, magnification, and helplessness about pain, is a well-known maladaptive pain-related thinking style. Among the three factors of PC, a cross-sectional study (see Craner et al., 2016) identified helplessness as being a predictor for pain intensity, pain interference, depression, and health-related quality of life (QOL) and magnification as being a predictor for depression and health-related QOL. However, pain rumination was not a significant predictor. To further identify maladaptive thinking styles in patients with chronic pain, the current study examined the three factors of PC as well as two non-pain related ruminative thinking styles as a predictor for pain intensity, pain bothersomeness, depression, anxiety, and anger.

Methods

The following surveys were administered to patients with mixed etiology chronic pain at baseline: the Pain Catastrophizing Scale (PCS), Ruminative Thought Style Questionnaire (RTSQ), and Ruminative Response Style (RRS). The PCS assesses the three factors of PC. The RTSQ and RRS assess general and negative emotion rumination patterns, respectively. Health outcome measures were the 0-10 Numerical Pain Intensity Rating, the 0-10 Pain Bothersomeness scale, and the PROMIS-Emotion Distress measures (depression, anxiety, anger), which were administered three months later. A total of 235 participants completed the surveys (Mage= 56.1±16.1 years, 72% female, 80% white, 70.1% with a college degree or higher). Five stepwise regression analyses were conducted. The alpha values of < 0.01 (= 0.05/5) were considered significant using Bonferroni correction. Analyses were performed in SPSS.

Results

Regression analyses revealed that pain intensity (? = 0.459, R2 = 0.211, p < .001) and pain bothersomeness (? = 0.446, R2 = 0.199, p < .001) were only predicted by the PCS-Helplessness scores to a moderate degree. Depression symptoms were predicted by the PCS-Helplessness scores to a large degree (? = 0.6, R2 = 0.360), and then the RRS scores to a smaller degree (? = 0.307, ?R2 = 0.078, all ps < 0.001). Anxiety symptoms were predicted by the PCS-Helplessness scores (? = 0.552, R2 = 0.304) to a large degree, then the RTSQ scores to a moderate degree (? = 0.384, ?R2 = 0.124), and the RRS scores to a small degree (? = 0.245, ?R2 = 0.040, all ps < 0.001). Anger symptoms were predicted by the RTSQ scores to a moderate degree (? = 0.463, ?R2 = 0.214), and then by the PCS-Helplessness scores to a small degree (? = 0.328, ?R2 = 0.091, all ps < 0.001).

Conclusions

Pain-related thinking style, particularly helplessness about pain, emerged as the sole significant predictor for pain intensity and pain bothersomeness three months later in patients with chronic pain. Additionally, helplessness about pain strongly predicted depression and anxiety symptoms while only weakly predicting anger symptoms. Interestingly, anger symptoms were best predicted by pain-unrelated, general ruminative tendency to a moderate degree.

References

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Presenting Author

Christiane Konstantopoulos

Poster Authors

Christiane Konstantopoulos

B.A.

Princeton University

Lead Author

E-mail

Topics

  • Mechanisms: Psychosocial and Biopsychosocial