title: Can people catastrophize barriers? An exploratory analysis of the association between pain catastrophizing and perceptions of environmental factors.
abstract: Measurement of the environment is taking on increased importance for understanding variability in participation. Most measures of the environment use subjective ratings, yet little is known about how people appraise the environment.
  
  
  
  /Hypothesis: We conducted this post-hoc study to examine whether or not catastrophizing, an important variable for understanding how pain contributes to disability, may be related to ratings of the environment. We hypothesized higher pain catastrophizing scores would be associated with greater environmental barriers and fewer facilitators.
  
  
  
  Individuals with functional impairments (N = 525) were recruited from a population-based random sample of households in a small western city in the United States to complete a paper-based survey about their health and community living experiences. We conducted exploratory regression analyses to investigate associations with environmental factor ratings.
  
  
  
  We found substantial associations between pain catastrophizing and both environmental barriers and personal factor problems after controlling for demographics, participation assessed by community trips per week, health conditions, impairment and pain level. The models accounted for 28% of the variance in environmental factor ratings and 52% of the variability personal factor ratings. We also present odds ratios for the association between personal characteristics and the likelihood of endorsing EF and PF.
  
  
  
  A variety of individual characteristics are associated with ratings of both environmental and personal factors that impact participation. Among these, pain catastrophizing is a robust predictor of EF and PF ratings which suggests future research designed specifically to test this relationship may generate useful results for developing interventions to increase participation.
authors.affiliation: Research and Training Center on Disability in Rural Communities, University of Montana, USA. Electronic address: Craig.Ravesloot@mso.umt.edu.
authors.forename: Craig
authors.initials: C
authors.lastname: Ravesloot
authors.affiliation: Research and Training Center on Disability in Rural Communities, University of Montana, USA.
authors.forename: Cathy
authors.initials: C
authors.lastname: Berendts
authors.affiliation: Research and Training Center on Disability in Rural Communities, University of Montana, USA.
authors.forename: Alex
authors.initials: A
authors.lastname: Schiwal
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001107:Architectural Accessibility; D058443:Catastrophization; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology*; D004777:Environment; D004779:Environment Design; D005191:Family Characteristics; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010146:Pain / Q000523:psychology*; D012044:Regression Analysis; D012931:Social Environment; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult
keywords: Catastrophizing; Chronic pain; Community living; Environmental factors; Participation