title: Pain Catastrophizing and Anxiety are Associated With Heat Pain Perception in a Community Sample of Adults With Chronic Pain.
abstract: The principle aim of this study was to investigate the associations between heat pain (HP) perception, pain catastrophizing, and pain-related anxiety in a heterogenous cohort of community-dwelling adults with chronic pain admitted to a 3-week outpatient pain rehabilitation program.
  
  
  
  All adults consecutively admitted to an outpatient pain rehabilitation program from July 2009 through January 2011 were eligible for study recruitment (n=574). Upon admission, patients completed the Pain Catastrophizing Scale (PCS), the short version of the Pain Anxiety Symptoms Scale (PASS-20), and HP perception was assessed using a standardized quantitative sensory testing (QST) method of levels.
  
  
  
  Greater PCS scores were significantly correlated with lower standardized values of HP threshold (HP 0.5) (P=0.006) and tolerance (HP 5) (P=0.003). In a multiple variable model adjusted for demographic and clinical factors known to influence HP perception, every 10-point increase in the PCS was associated with a -0.124 point change in HP 0.5 (P=0.014) and a -0.142 change in HP 5 (P=0.014) indicating that participants with higher PCS scores had lower HP thresholds and tolerances, respectively. Similarly, greater PASS-20 scores significantly correlated with lower standardized values of HP 0.5 and HP 5. In a multiple variable model, every 10-point increase in the PASS-20 was associated with a -0.084 point change in HP 0.5 (P=0.005) and a -0.116 point change in HP 5 (P=0.001) indicating that participants with higher PASS-20 scores had lower HP thresholds and tolerances, respectively.
  
  
  
  The findings of this study extend the use of a standardized method for assessing HP in a heterogenous sample of adults with chronic pain. Although pain catastrophizing shares significant variance with pain-related anxiety, our findings suggest that either measure would be appropriate for use in future studies that incorporate the QST method of levels.
authors.affiliation: *Mayo Clinic School of Postgraduate Education †Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: Marisa J
authors.initials: MJ
authors.lastname: Terry
authors.forename: Susan M
authors.initials: SM
authors.lastname: Moeschler
authors.forename: Bryan C
authors.initials: BC
authors.lastname: Hoelzer
authors.forename: W Michael
authors.initials: WM
authors.lastname: Hooten
mesh_terms: D001007:Anxiety; D058443:Catastrophization; D059350:Chronic Pain / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D006358:Hot Temperature; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D058748:Pain Perception; D017288:Pain Threshold; D011569:Psychiatric Status Rating Scales; D057566:Self Report