Moderators of the negative effects of catastrophizing in arthritis.
OBJECTIVE
Pain is among the most frequently reported, bothersome, and disabling symptoms described by patients with rheumatoid arthritis (RA), and the experience of pain is partially shaped by catastrophizing, a set of cognitive and emotional pain-related processes. However, other variables may moderate catastrophizing's influence on the experience of pain. In this study, we investigated a variety of factors that might buffer or magnify catastrophizing's deleterious consequences among patients with RA.


METHODS
A total of 185 RA patients were surveyed to determine levels of catastrophizing, pain, general psychological distress, and physical functioning.


RESULTS
Catastrophizing was associated with increased pain severity and psychological distress, and with poorer physical functioning. Some of these relationships were significantly moderated by education and social functioning; among RA patients with above-average social functioning and a college education, minimal relationships of catastrophizing with pain and distress symptoms were observed, while these associations were highly significant (Ps < 0.001) among patients with lower levels of education or social functioning.


CONCLUSIONS
Collectively, educational achievement and positive social interactions may protect against some of the deleterious effects of catastrophizing. The design of future interventions to reduce catastrophizing or ameliorate its impact on pain outcomes may benefit from further study of these subgroups of patients.
Edwards
Robert R
RR
Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Chestnut Hill, MA 02467, USA. rredwards@partners.org
Giles
Jon
J
Bingham
Clifton O
CO
Campbell
Claudia
C
Haythornthwaite
Jennifer A
JA
Bathon
Joan
J
D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D001294:Attitude to Health; D004522:Educational Status; D005260:Female; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology* / Q000523:psychology*; D010147:Pain Measurement; D011795:Surveys and Questionnaires