Catastrophic appraisal of acute and chronic pain in a population sample of new jersey national guard troops.
OBJECTIVE
Catastrophic appraisal has been implicated as a possible cause of psychiatric morbidity, psychological distress, and physical impairment in individuals with chronic pain. At issue in this study was whether catastrophizing was associated with psychiatric morbidity in a population sample of National Guard members. In addition, we sought to determine whether it could account for individual differences in psychological distress and impaired physical function in the presence of acute and chronic pain.


METHODS
We performed a secondary analysis of an existing survey database. The original survey was designed to assess combat readiness in a population sample of 2995 National Guard troops about to deploy overseas. The database included screening instruments for psychiatric illness as well as continuous measures of psychological distress, pain perception, pain catastrophizing, and perceived physical function.


RESULTS
Among Guard members reporting a problem with pain, frequent catastrophizing was associated with higher rates of depression, posttraumatic stress, alcohol dependence, and somatization-like illness. Higher rates were also associated with chronic as opposed to acute pain (except for alcohol dependence). Pain-related catastrophizing accounted for substantial variance in measures of psychological distress and physical impairment regardless of pain duration.


CONCLUSIONS
Although catastrophizing beliefs are common in clinical settings, this study suggests that the phenomenon may be prevalent in the population at large and likely to influence the outcome of acute as well as chronic pain.
Ciccone
Donald S
DS
Department of Psychiatry, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey 07103, USA. cicconds@umdnj.edu
Chandler
Helena K
HK
Kline
Anna
A
D000208:Acute Disease; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D058443:Catastrophization / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D057189:Checklist / Q000379:methods; D002908:Chronic Disease; D005260:Female; D006306:Health Surveys; D006801:Humans; D007206:Individuality; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D009515:New Jersey / Q000453:epidemiology; D010146:Pain / Q000145:classification / Q000150:complications* / Q000453:epidemiology* / Q000523:psychology; D010147:Pain Measurement; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires