title: Pain catastrophizing as repetitive negative thinking: a development of the conceptualization.
abstract: Pain catastrophizing is a well-known concept in the pain literature and has been recognized as one of the most powerful psychological determinants of negative outcomes for pain problems. However, relatively little effort has been put into developing its theoretical underpinnings. More specifically, the intrinsic function of catastrophizing is not explicitly dealt with in contemporary theoretical models. The aim of this article is to add to existing models by proposing a development of the conceptualization of catastrophizing that stresses its function as an emotion regulator. We argue that catastrophizing can be conceptualized as a form of negative repetitive thinking, which is abstract, intrusive, and difficult to disengage from. It has been argued that repetitive negative thinking is a form of ineffective problem solving that functions to downregulate negative affect and that it can be regarded as an avoidant coping strategy because it impedes processing of emotional and somatic responses. Thus, in our conceptualization, catastrophizing is proposed to be a form of problem-solving behavior that functions to reduce negative emotion triggered by pain, and other related stimuli. Furthermore, we argue that catastrophizing is preferably regarded as a process where cognitions, emotions, and overt behavior are intertwined and not viewed as separate entities. To underscore the latter, we suggest the term catastrophic worry. Our intention with this development of the conceptualization is to give rise to new ideas for research and clinical practice and to revitalize discussions about the theoretical framework around pain-related catastrophizing.
authors: Center of Health and Medical Psychology, School of Law, Psychology, and Social Work, Örebro University, Sweden. ida.flink@oru.se
authors: Ida Landström
authors: IL
authors: Flink
authors: Katja
authors: K
authors: Boersma
authors: Steven J
authors: SJ
authors: Linton
mesh_terms: D001007:Anxiety / Q000523:psychology; D001288:Attention; D058443:Catastrophization / Q000523:psychology*; D006801:Humans; D008960:Models, Psychological; D010146:Pain / Q000523:psychology*; D013850:Thinking
references: Behav Res Ther. 2007 Jun;45(6):1231-43
references: 17054902
references: Eur J Pain. 2006 May;10(4):287-333
references: 16095934
references: J Behav Med. 2007 Feb;30(1):77-94
references: 17180640
references: Behav Res Ther. 2010 Feb;48(2):134-40
references: 19878928
references: Eur Arch Psychiatry Clin Neurosci. 2007 Dec;257(8):462-72
references: 17629726
references: Clin J Pain. 2001 Jun;17(2):165-72
references: 11444718
references: J Ration Emot Cogn Behav Ther. 2009 Sep;27(3):160-175
references: 19718267
references: J Abnorm Psychol. 1998 Nov;107(4):576-86
references: 9830245
references: Pain. 2009 Sep;145(1-2):6-7
references: 19520511
references: J Behav Ther Exp Psychiatry. 2011 Jun;42(2):225-32
references: 21315886
references: Pain. 2003 Nov;106(1-2):1-2
references: 14581103
references: Behav Res Ther. 1990;28(6):455-68
references: 2076083
references: Pain. 2004 Oct;111(3):226-229
references: 15363864
references: Pain. 2000 Apr;85(3):317-332
references: 10781906
references: Pain. 2007 Dec 5;132(3):233-236
references: 17961924
references: Phys Ther. 2011 May;91(5):737-53
references: 21451099
references: Pain. 2003 Nov;106(1-2):19-25
references: 14581106
references: Pain. 2002 Nov;100(1-2):47-53
references: 12435458
references: Psychol Bull. 2008 Mar;134(2):163-206
references: 18298268
references: Phys Ther. 2011 May;91(5):700-11
references: 21451097
references: Clin J Pain. 2001 Mar;17(1):65-71
references: 11289090
references: Pain. 2004 Aug;110(3):512-516
references: 15288391
references: Behav Res Ther. 1983;21(1):9-16
references: 6830571
references: Pain. 2009 Nov;146(1-2):222; author reply 222-3
references: 19775814
references: J Abnorm Psychol. 2001 Feb;110(1):83-96
references: 11261404
references: Behav Res Ther. 1998 Jul-Aug;36(7-8):751-6
references: 9682529
references: J Pain. 2004 May;5(4):195-211
references: 15162342
references: Pain. 2007 Feb;127(3):276-286
references: 17071000
references: Clin J Pain. 2001 Mar;17(1):52-64
references: 11289089
references: J Rheumatol. 2001 Jun;28(6):1369-77
references: 11409133
references: Expert Rev Neurother. 2009 May;9(5):745-58
references: 19402782
references: Pain. 2003 May;103(1-2):151-6
references: 12749969
references: Pain. 2004 Aug;110(3):597-604
references: 15288400
references: Eur J Pain. 2010 Sep;14(8):887-92
references: 20219398
references: Pain. 2009 Sep;145(1-2):45-51
references: 19477072
references: Pain. 1983 Sep;17(1):33-44
references: 6226916
references: Pain. 2004 Feb;107(3):220-226
references: 14736584