title: Changes in pain catastrophizing predict later changes in fibromyalgia clinical and experimental pain report: cross-lagged panel analyses of dispositional and situational catastrophizing.
abstract: BACKGROUND
  Fibromyalgia (FM), characterized by wide-spread diffuse pain and sensory abnormalities, is associated with elevated indices of distress and pain-related catastrophizing compared to both pain-free samples and those with chronic pain conditions. Catastrophizing is a pervasive negative mental set, and is a strong predictor of negative pain-related outcomes such as clinical pain intensity, and physical disability. Situational catastrophizing, measured in the context of experimentally-induced pain, is strongly related to enhanced pain sensitivity, a core aspect of the pathophysiology of fibromyalgia. However, little is known regarding the temporal course of the association between catastrophizing and pain-related "outcomes". Most studies involve only static assessments of pain and catastrophizing at a single time point, which provides little insight into the direction of the observed associations. We sought to investigate the temporal relationships between catastrophizing and indices of both clinical pain (substudy 1) and experimentally-induced pain (substudy 2) in a larger randomized controlled longitudinal trial.
  
  
  METHODS
  Fifty-seven patients with FM completed catastrophizing, depression, and pain questionnaires as well as laboratory cold pressor pain testing at baseline, post-intervention and three month follow-up during a lifestyle physical activity study. Cross-lagged panel analyses were used to address these temporal relationships.
  
  
  RESULTS
  In substudy 1, analyses revealed that pre-to-post changes in dispositional catastrophizing ratings prospectively accounted for unique variance in subsequent post-to-follow-up changes in clinical pain ratings (p = 0.005), while pre-to-post changes in pain ratings did not account for unique variance in post-to-follow-up changes in catastrophizing ratings. An identical pattern was observed experimentally in substudy 2, with pre-to-post changes in situational catastrophizing ratings prospectively accounting for unique variance in subsequent post-to-follow-up changes in experimental pain ratings (p = 0.014), while pre-to-post changes in pain ratings did not account for unique variance in post-to-follow-up changes in catastrophizing ratings. Specifically, initial alterations in catastrophizing were associated with subsequent alterations in clinical and experimentally induced pain. Controlling for levels of depression did not affect the results.
  
  
  CONCLUSIONS
  These findings provide empirical evidence that catastrophizing processes might precede and contribute to subsequent alterations in the pain experience for FM patients.
  
  
  BACKGROUND
  clinicaltrials.gov: NCT00383084.
authors.forename: Claudia M
authors.initials: CM
authors.lastname: Campbell
authors.forename: Lea
authors.initials: L
authors.lastname: McCauley
authors.forename: Sara C
authors.initials: SC
authors.lastname: Bounds
authors.forename: Vani A
authors.initials: VA
authors.lastname: Mathur
authors.forename: Lora
authors.initials: L
authors.lastname: Conn
authors.forename: Mpepera
authors.initials: M
authors.lastname: Simango
authors.forename: Robert R
authors.initials: RR
authors.lastname: Edwards
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Fontaine
mesh_terms: D000328:Adult; D058443:Catastrophization / Q000523:psychology*; D015984:Causality; D003072:Cognition Disorders / Q000503:physiopathology / Q000523:psychology; D003863:Depression / Q000503:physiopathology / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D005356:Fibromyalgia / Q000503:physiopathology* / Q000523:psychology* / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D010146:Pain / Q000503:physiopathology* / Q000523:psychology*; D010147:Pain Measurement; D010353:Patient Education as Topic; D012044:Regression Analysis; D011795:Surveys and Questionnaires