Dimensions of catastrophic thinking associated with pain experience and disability in patients with neuropathic pain conditions.
The objective of the present study was to examine the relative contributions of different dimensions of catastrophic thinking (i.e. rumination, magnification, helplessness) to the pain experience and disability associated with neuropathic pain. Eighty patients with diabetic neuropathy, post-herpetic neuralgia, post-surgical or post-traumatic neuropathic pain who had volunteered for participation in a clinical trial formed the basis of the present analyses. Spontaneous pain was assessed with the sensory and affective subscales of the McGill Pain Questionnaire. Pinprick hyperalgesia and dynamic tactile allodynia were used as measures of evoked pain. Consistent with previous research, individuals who scored higher on a measure of catastrophic thinking (Pain Catastrophizing Scale; PCS) also rated their pain as more intense, and rated themselves to be more disabled due to their pain. Follow up analyses revealed that the PCS was significantly correlated with the affective subscale of the MPQ but not with the sensory subscale. The helplessness subscale of the PCS was the only dimension of catastrophizing to contribute significant unique variance to the prediction of pain. The PCS was not significantly correlated with measures of evoked pain. Catastrophizing predicted pain-related disability over and above the variance accounted for by pain severity. The findings are discussed in terms of mechanisms linking catastrophic thinking to pain experience. Treatment implications are addressed.
Sullivan
Michael J L
MJL
Department of Psychology, University of Montreal, C.P. 6128 Succ Centre Ville, Montreal, Que., Canada H3C 3J7 Pain Management Unit, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS, Canada Department Anesthesia, Pain Management Unit, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS, Canada.
Lynch
Mary E
ME
Clark
A J
AJ
D000223:Adaptation, Psychological; D000328:Adult; D000342:Affective Symptoms / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000145:classification / Q000503:physiopathology* / Q000523:psychology*; D010147:Pain Measurement; D017288:Pain Threshold / Q000523:psychology; D010523:Peripheral Nervous System Diseases / Q000503:physiopathology / Q000523:psychology; D012044:Regression Analysis; D011795:Surveys and Questionnaires