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Robert R. Edwards - One of the best experts on this subject based on the ideXlab platform.
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interactive effects of pain Catastrophizing and mindfulness on pain intensity in women with fibromyalgia
Health psychology open, 2018Co-Authors: K Dorado, Robert R. Edwards, Kristin L Schreiber, Alexandra Koulouris, Vitaly Napadow, Asimina LazaridouAbstract:The objective of this study was to examine the association between facets of trait mindfulness, pain Catastrophizing, and pain severity in a sample of patients with fibromyalgia. Patients with fibromyalgia completed validated baseline and diary assessments of clinical pain, mindfulness, and pain Catastrophizing. Multilevel modeling analyses indicated that the daily association between Catastrophizing and pain intensity was moderated by certain mindfulness facets. Our findings suggest that various aspects of mindfulness may interact differently with pain and Catastrophizing, which may have implications for the design and testing of interventions targeting mindfulness and Catastrophizing in fibromyalgia patients.
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disease related nondisease related and situational Catastrophizing in sickle cell disease and its relationship with pain
The Journal of Pain, 2016Co-Authors: Jennifer A Haythornthwaite, Robert R. Edwards, Vani A Mathur, Kasey B Kiley, Patrick C Carroll, Sophie Lanzkron, C CampbellAbstract:Abstract Catastrophizing is a potent psychological modulator of pain across several chronic pain populations; yet despite evidence that patients with sickle cell disease (SCD) catastrophize more than patients with other chronic pain conditions, previous research indicates that Catastrophizing is not related to sickle cell pain after controlling for relevant covariates such as depression. Recent research suggests that pain-related Catastrophizing should be assessed across pain contexts (eg, dispositional and situational). In this study, we measured disease-specific, general non-disease-related, and situational Catastrophizing and assessed the relationship between these contextual dimensions of Catastrophizing and laboratory and clinical pain among patients with SCD. Results revealed differential Catastrophizing across pain contexts, with patients reporting greater Catastrophizing about SCD-specific pain compared with non-SCD pain and laboratory pain. SCD-specific and non-SCD Catastrophizing were associated with clinical pain outcomes, and situational Catastrophizing with markers of central sensitization and laboratory pain. Further examination of the time course of laboratory responses revealed that increases in situational Catastrophizing were associated with subsequent increases in laboratory pain sensitivity. Taken together, results show the relevance of Catastrophizing in understanding pain in SCD, and suggest that context-specific anchors may be beneficial in predicting different aspects of the pain experience (eg, chronic pain, pain sensitization). Perspective Patients with SCD report greater Catastrophizing about sickle cell-specific pain relative to other pains. Disease-specific and non-disease-related pain Catastrophizing were associated with clinical pain, and situational Catastrophizing predictive of subsequent laboratory pain. Evaluation of context-specific Catastrophizing may more accurately predict different aspects of the pain experience.
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effects of cognitive behavioral therapy cbt on brain connectivity supporting Catastrophizing in fibromyalgia
The Clinical Journal of Pain, 2016Co-Authors: Asimina Lazaridou, O Franceschelli, Marco L Loggia, Vitaly Napadow, Chantal Berna, Jieun Kim, Christine M Cahalan, Peter H Schur, Robert R. EdwardsAbstract:OBJECTIVE(S) Fibromyalgia (FM) is a chronic, common pain disorder characterized by hyperalgesia. A key mechanism by which cognitive-behavioral therapy (CBT) fosters improvement in pain outcomes is via reductions in hyperalgesia and pain-related Catastrophizing, a dysfunctional set of cognitive-emotional processes. However, the neural underpinnings of these CBT effects are unclear. Our aim was to assess CBT's effects on the brain circuitry underlying hyperalgesia in FM patients, and to explore the role of treatment-associated reduction in Catastrophizing as a contributor to normalization of pain-relevant brain circuitry and clinical improvement. METHODS In total, 16 high-Catastrophizing FM patients were enrolled in the study and randomized to 4 weeks of individual treatment with either CBT or a Fibromyalgia Education (control) condition. Resting state functional magnetic resonance imaging scans evaluated functional connectivity between key pain-processing brain regions at baseline and posttreatment. Clinical outcomes were assessed at baseline, posttreatment, and 6-month follow-up. RESULTS Catastrophizing correlated with increased resting state functional connectivity between S1 and anterior insula. The CBT group showed larger reductions (compared with the education group) in Catastrophizing at posttreatment (P<0.05), and CBT produced significant reductions in both pain and Catastrophizing at the 6-month follow-up (P<0.05). Patients in the CBT group also showed reduced resting state connectivity between S1 and anterior/medial insula at posttreatment; these reductions in resting state connectivity were associated with concurrent treatment-related reductions in Catastrophizing. DISCUSSION The results add to the growing support for the clinically important associations between S1-insula connectivity, clinical pain, and Catastrophizing, and suggest that CBT may, in part via reductions in Catastrophizing, help to normalize pain-related brain responses in FM.
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changes in pain Catastrophizing predict later changes in fibromyalgia clinical and experimental pain report cross lagged panel analyses of dispositional and situational Catastrophizing
Arthritis Research & Therapy, 2012Co-Authors: C Campbell, Robert R. Edwards, Mpepera Simango, Vani A Mathur, L Mccauley, S Bounds, Lora Conn, Kevin R FontaineAbstract: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. 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. 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. These findings provide empirical evidence that Catastrophizing processes might precede and contribute to subsequent alterations in the pain experience for FM patients. clinicaltrials.gov: NCT00383084 .
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evidence for indirect effects of pain Catastrophizing on clinical pain among myofascial temporomandibular disorder participants the mediating role of sleep disturbance
Pain, 2012Co-Authors: L Buenaver, Jennifer A Haythornthwaite, Phillip J. Quartana, Robert R. Edwards, Edward G Grace, Eleni Sarlani, Mpepera Simango, Michael T SmithAbstract:Abstract Sleep disturbance and pain Catastrophizing are important mediators of the chronic pain experience. To date, these factors have not been considered concurrently despite compelling theoretical rationale to do so. In the present study, we examined whether pain Catastrophizing not only has direct effects on clinical pain and pain-related interference, but also indirect effects through its association with sleep disturbance. We evaluated this hypothesis using a cohort ( n = 214) of myofascial temporomandibular disorder participants using a statistical bootstrapping technique recommended for tests of indirect effects. Results suggested that pain Catastrophizing was associated with greater sleep disturbance, and that a significant portion of variance in clinical pain severity and pain-related interference attributable to pain Catastrophizing was mediated by sleep disturbance. Supplementary analyses revealed that the rumination component of Catastrophizing seemed to be indirectly related to clinical outcomes through sleep disturbance. No evidence for indirect effects was observed for helplessness and magnification components. These results suggest that rumination about pain may contribute to clinical pain indirectly through alterations in sleep. Prospective studies are needed to examine lagged associations between these constructs. These findings have important theoretical and clinical implications. Critically, interventions that reduce pain Catastrophizing may concurrently improve sleep and clinical pain.
Jennifer A Haythornthwaite - One of the best experts on this subject based on the ideXlab platform.
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disease related nondisease related and situational Catastrophizing in sickle cell disease and its relationship with pain
The Journal of Pain, 2016Co-Authors: Jennifer A Haythornthwaite, Robert R. Edwards, Vani A Mathur, Kasey B Kiley, Patrick C Carroll, Sophie Lanzkron, C CampbellAbstract:Abstract Catastrophizing is a potent psychological modulator of pain across several chronic pain populations; yet despite evidence that patients with sickle cell disease (SCD) catastrophize more than patients with other chronic pain conditions, previous research indicates that Catastrophizing is not related to sickle cell pain after controlling for relevant covariates such as depression. Recent research suggests that pain-related Catastrophizing should be assessed across pain contexts (eg, dispositional and situational). In this study, we measured disease-specific, general non-disease-related, and situational Catastrophizing and assessed the relationship between these contextual dimensions of Catastrophizing and laboratory and clinical pain among patients with SCD. Results revealed differential Catastrophizing across pain contexts, with patients reporting greater Catastrophizing about SCD-specific pain compared with non-SCD pain and laboratory pain. SCD-specific and non-SCD Catastrophizing were associated with clinical pain outcomes, and situational Catastrophizing with markers of central sensitization and laboratory pain. Further examination of the time course of laboratory responses revealed that increases in situational Catastrophizing were associated with subsequent increases in laboratory pain sensitivity. Taken together, results show the relevance of Catastrophizing in understanding pain in SCD, and suggest that context-specific anchors may be beneficial in predicting different aspects of the pain experience (eg, chronic pain, pain sensitization). Perspective Patients with SCD report greater Catastrophizing about sickle cell-specific pain relative to other pains. Disease-specific and non-disease-related pain Catastrophizing were associated with clinical pain, and situational Catastrophizing predictive of subsequent laboratory pain. Evaluation of context-specific Catastrophizing may more accurately predict different aspects of the pain experience.
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evidence for indirect effects of pain Catastrophizing on clinical pain among myofascial temporomandibular disorder participants the mediating role of sleep disturbance
Pain, 2012Co-Authors: L Buenaver, Jennifer A Haythornthwaite, Phillip J. Quartana, Robert R. Edwards, Edward G Grace, Eleni Sarlani, Mpepera Simango, Michael T SmithAbstract:Abstract Sleep disturbance and pain Catastrophizing are important mediators of the chronic pain experience. To date, these factors have not been considered concurrently despite compelling theoretical rationale to do so. In the present study, we examined whether pain Catastrophizing not only has direct effects on clinical pain and pain-related interference, but also indirect effects through its association with sleep disturbance. We evaluated this hypothesis using a cohort ( n = 214) of myofascial temporomandibular disorder participants using a statistical bootstrapping technique recommended for tests of indirect effects. Results suggested that pain Catastrophizing was associated with greater sleep disturbance, and that a significant portion of variance in clinical pain severity and pain-related interference attributable to pain Catastrophizing was mediated by sleep disturbance. Supplementary analyses revealed that the rumination component of Catastrophizing seemed to be indirectly related to clinical outcomes through sleep disturbance. No evidence for indirect effects was observed for helplessness and magnification components. These results suggest that rumination about pain may contribute to clinical pain indirectly through alterations in sleep. Prospective studies are needed to examine lagged associations between these constructs. These findings have important theoretical and clinical implications. Critically, interventions that reduce pain Catastrophizing may concurrently improve sleep and clinical pain.
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relationship of depression and Catastrophizing to pain disability and medication adherence in patients with hiv associated sensory neuropathy
Aids Care-psychological and Socio-medical Aspects of Aids\ hiv, 2011Co-Authors: Brendan P Lucey, Robert R. Edwards, David B Clifford, Jason Creighton, Justin C Mcarthur, Jennifer A HaythornthwaiteAbstract:Abstract Few studies have examined how patients with chronic HIV infection cope with pain and how pain relates to medication adherence. Pain coping strategies such as Catastrophizing are often associated with increased pain and disability and may also influence adherence to medications. The goal of our study is to assess the relationship of Catastrophizing and depression to pain, disability, and medication adherence through questionnaires administered to a cross-section of patients with HIV-associated sensory neuropathy. In our study, 46 HIV-seropositive subjects completed questionnaires evaluating neuropathic pain severity, pain Catastrophizing, pain-related disability, depressive symptoms, severity of antiretroviral therapy (ART) side effects, and common reasons for medication nonadherence. Hierarchical regression analysis indicated that pain Catastrophizing correlated with severity of neuropathic pain independent of depressive symptoms. Furthermore, depressive symptoms were not associated with multiple...
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situational versus dispositional measurement of Catastrophizing associations with pain responses in multiple samples
The Journal of Pain, 2010Co-Authors: C Campbell, Jennifer A Haythornthwaite, Robert R. Edwards, L Buenaver, Michael T Smith, Tarek Kronfli, Chantal BernaAbstract:Abstract Catastrophizing is widely recognized as an important risk factor for adverse pain-related outcomes. However, questions remain surrounding the details of its assessment. In particular, recent laboratory studies suggest that evaluation of “situational” Catastrophizing (ie, Catastrophizing measured during or directly after the administration of noxious stimulation) may provide information distinct from that obtained by standard, or “dispositional” measures, which assess individuals' recall of Catastrophizing in daily life. However, comparatively little research has systematically investigated the interrelationships and properties of these 2 different forms of pain-related Catastrophizing. The current study evaluated both situational and dispositional Catastrophizing measures within multiple samples: healthy individuals (N = 84), patients with painful temporomandibular joint disorders (TMD; N = 48), and patients with painful arthritis (N = 43). All participants first completed the Pain Catastrophizing Scale (PCS), and then underwent psychophysical pain testing, which included heat, cold, and pressure pain. Participants then completed a situational Catastrophizing measure with reference to the laboratory pain he/she had just undergone. Situational Catastrophizing scores were not significantly correlated with dispositional PCS scores in the healthy participants and arthritis patients, though they were associated in TMD patients. Situational Catastrophizing was more strongly associated with experimental pain responses than dispositional PCS scores for the healthy subjects and arthritis patients. In general, higher levels of situational Catastrophizing were associated with lower pain thresholds and higher pain ratings across all 3 samples. The findings highlight the importance of multidimensional assessment of pain-related Catastrophizing, and suggests a role for measuring Catastrophizing related to specific, definable events. Perspective This study adds to a growing literature examining Catastrophizing. Our findings highlight the potential importance of the multidimensional assessment of pain-related Catastrophizing, and suggest a role for measuring Catastrophizing related to specific, definable events.
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Catastrophizing and depressive symptoms as prospective predictors of outcomes following total knee replacement
Pain Research & Management, 2009Co-Authors: Robert R. Edwards, Jennifer A Haythornthwaite, Michael T Smith, Brendan Klick, Jeffrey N KatzAbstract:Several recent reports suggest that pain-related Catastrophizing is a risk factor for poor acute pain outcomes following surgical interventions. However, it has been less clear whether levels of Catastrophizing influence longer-term postoperative outcomes. Data were analyzed from a relatively small number (n=43) of patients who underwent total knee replacement and were followed for 12 months after their surgery. Previous research has suggested that high levels of both Catastrophizing and depression are associated with elevated acute postoperative pain complaints among patients undergoing knee surgery. In this sample, Catastrophizing and depression at each of the assessment points were studied as prospective predictors of pain (both global pain ratings and pain at night) at the subsequent assessment point over the course of one year. The predictive patterns differed somewhat across measures of pain reporting; depressive symptoms were unique predictors of greater global pain complaints, while Catastrophizing was a specific and unique predictor of elevated nighttime pain. While surgical outcomes following total knee replacement are, on average, quite good, a significant minority of patients continue to experience long-term pain. The present findings suggest that high levels of Catastrophizing and depression may promote enhanced pain levels, indicating that interventions designed to reduce Catastrophizing and depressive symptoms may have the potential to further improve joint replacement outcomes.
Johan W S Vlaeyen - One of the best experts on this subject based on the ideXlab platform.
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pain Catastrophizing threat and the informational value of mood task persistence during a painful finger pressing task
Pain, 2012Co-Authors: Petra A. Karsdorp, Martien G S Schrooten, Stewart Ranson, Johan W S VlaeyenAbstract:Abstract Pain Catastrophizing has shown to predict avoidance behavior in acute and chronic pain, but the literature is inconsistent. The present study tested the hypothesis that current mood and threat context moderate the relationship between pain Catastrophizing and performance duration. Affective-motivational models postulate that negative and positive moods provide information about whether an activity is respectively threatening or safe. Moreover, it has been proposed that stable cognitive schemas about threat influence behavior particularly in threat-relevant contexts. The present study aimed to establish whether pain Catastrophizing is related to less or greater performance duration, when participants experience respectively negative or positive moods, particularly in a high threatening pain context. A 2 mood × 2 threat context between-subjects factorial design was applied in 89 healthy participants with pain Catastrophizing as covariate and performance duration during a painful finger pressing task as dependent variables. As predicted, higher pain Catastrophizing was associated with less performance duration when participants experienced negative moods. The opposite was found when participants experienced positive moods. Moreover, these relationships were most pronounced in a high threatening pain context. This study suggests that the relationship between pain Catastrophizing and performance duration during painful activities is moderated by situational factors such as current mood and threat context.
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s401 pain Catastrophizing threat and the informational value of mood task persistence during a painful finger pressing task
European Journal of Pain Supplements, 2011Co-Authors: Petra A. Karsdorp, Martien G S Schrooten, Stewart Ranson, Johan W S VlaeyenAbstract:Pain Catastrophizing has shown to predict avoidance behavior in acute and chronic pain, but the litera- ture is inconsistent. The present study tested the hypothesis that current mood and threat context mod- erate the relationship between pain Catastrophizing and performance duration. Affective-motivational models postulate that negative and positive moods provide information about whether an activity is respectively threatening or safe. Moreover, it has been proposed that stable cognitive schemas about threat influence behavior particularly in threat-relevant contexts. The present study aimed to establish whether pain Catastrophizing is related to less or greater performance duration, when participants experience respectively negative or positive moods, particularly in a high threatening pain context. A 2 mood 2 threat context between-subjects factorial design was applied in 89 healthy participants with pain Catastrophizing as covariate and performance duration during a painful finger pressing task as dependent variables. As predicted, higher pain Catastrophizing was associated with less performance duration when participants experienced negative moods. The opposite was found when participants experienced positive moods. Moreover, these relationships were most pronounced in a high threatening pain context. This study suggests that the relationship between pain Catastrophizing and performance duration during painful activities is moderated by situational factors such as current mood and threat context.
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reduction of pain Catastrophizing mediates the outcome of both physical and cognitive behavioral treatment in chronic low back pain
The Journal of Pain, 2006Co-Authors: Rob J E M Smeets, Arnold D. M. Kester, Johan W S Vlaeyen, Andre J KnottnerusAbstract:UNLABELLED: The aim of this study was to examine whether treatments based on different theories change pain Catastrophizing and internal control of pain, and whether changes in these factors mediate treatment outcome. Participants were 211 patients with nonspecific chronic low back pain (CLBP) participating in a randomized controlled trial, attending active physical treatment (APT, n = 52), cognitive-behavioral treatment (CBT, n = 55), treatment combining the APT and CBT (CT, n = 55), or waiting list (WL, n = 49). Pain Catastrophizing decreased in all 3 active treatment groups and not in the WL. There was no difference in the change in internal control across all 4 groups. In all the active treatment groups, patients improved regarding perceived disability, main complaints, and current pain at post-treatment, and no changes were observed in the WL group. Depression only changed significantly in the APT group. Change in pain Catastrophizing mediated the reduction of disability, main complaints, and pain intensity. In the APT condition, pain Catastrophizing also mediated the reduction of depression. Not only cognitive-behavioral treatments but also a physical treatment produced changes in pain Catastrophizing that seemed to mediate the outcome of the treatment significantly. The implications and limitations of these results are discussed. PERSPECTIVE: This article shows that treatment elements that do not deliberately target cognitive factors can reduce pain Catastrophizing. Reduction in pain Catastrophizing seemed to mediate the improvement of functioning in patients with chronic low back pain. The results might contribute to the development of more effective interventions.
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reduction of pain Catastrophizing mediates the outcome of both physical and cognitive behavioral treatment in chronic low back pain
The Journal of Pain, 2006Co-Authors: Rob J E M Smeets, Arnold D. M. Kester, Johan W S Vlaeyen, Andre J KnottnerusAbstract:Abstract The aim of this study was to examine whether treatments based on different theories change pain Catastrophizing and internal control of pain, and whether changes in these factors mediate treatment outcome. Participants were 211 patients with nonspecific chronic low back pain (CLBP) participating in a randomized controlled trial, attending active physical treatment (APT, n = 52), cognitive-behavioral treatment (CBT, n = 55), treatment combining the APT and CBT (CT, n = 55), or waiting list (WL, n = 49). Pain Catastrophizing decreased in all 3 active treatment groups and not in the WL. There was no difference in the change in internal control across all 4 groups. In all the active treatment groups, patients improved regarding perceived disability, main complaints, and current pain at post-treatment, and no changes were observed in the WL group. Depression only changed significantly in the APT group. Change in pain Catastrophizing mediated the reduction of disability, main complaints, and pain intensity. In the APT condition, pain Catastrophizing also mediated the reduction of depression. Not only cognitive-behavioral treatments but also a physical treatment produced changes in pain Catastrophizing that seemed to mediate the outcome of the treatment significantly. The implications and limitations of these results are discussed. Perspective This article shows that treatment elements that do not deliberately target cognitive factors can reduce pain Catastrophizing. Reduction in pain Catastrophizing seemed to mediate the improvement of functioning in patients with chronic low back pain. The results might contribute to the development of more effective interventions.
Michael J L Sullivan - One of the best experts on this subject based on the ideXlab platform.
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heritability of pain Catastrophizing and associations with experimental pain outcomes a twin study
Pain, 2015Co-Authors: Zina Trost, Eric Strachan, Michael J L Sullivan, Tine Vervoort, Ally R Avery, Niloofar AfariAbstract:The current study employed a twin paradigm to examine the genetic and environmental contributions to pain Catastrophizing as well as the observed association between pain Catastrophizing and cold pressor task (CPT) outcomes. Male and female monozygotic (n=206) and dizygotic twins (n=194) from the University of Washington Twin Registry completed a measure of pain Catastrophizing and performed a CPT challenge. As expected, pain Catastrophizing emerged as a significant predictor of several CPT outcomes, including cold pressor immersion tolerance, pain tolerance, and delayed pain rating. The heritability estimate for pain Catastrophizing was found to be 37% with the remaining 63% of variance attributable to unique environmental influence. Additionally, the observed associations between pain Catastrophizing and CPT outcomes were not found attributable to shared genetics or environmental exposure, suggesting a direct relationship between Catastrophizing and experimental pain outcomes. This study is the first to examine the heritability of pain Catastrophizing and potential processes by which pain Catastrophizing is related to experimental pain response.
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clinically meaningful scores on pain Catastrophizing before and after multidisciplinary rehabilitation a prospective study of individuals with subacute pain after whiplash injury
The Clinical Journal of Pain, 2014Co-Authors: Whitney Scott, Timothy H Wideman, Michael J L SullivanAbstract:Objectives: Pain Catastrophizing has emerged as a significant risk factor for problematic recovery after musculoskeletal injury. As such, there has been an increased focus on interventions that target patients’ levels of Catastrophizing. However, it is not presently clear how clinicians might best interpret scores on Catastrophizing before and after treatment. Thus, the purpose of this study was to provide preliminary guidelines for the clinical interpretation of scores on pain Catastrophizing among individuals with subacute pain after musculoskeletal injury. Methods: A sample of 166 occupationally disabled individuals with subacute pain due to a whiplash injury participated in this study. Participants completed a 7-week standardized multidisciplinary rehabilitation program aimed at fostering functional recovery. Participants completed the Pain Catastrophizing Scale (PCS) upon program commencement and completion. One year later, participants indicated their pain severity and involvement in employment activities. Separate receiver operating characteristic curve analyses were conducted to determine absolute pretreatment and posttreatment and percent change scores on the PCS that were best associated with clinically important levels of pain and employment status at the follow-up. Results: An absolute pretreatment PCS score of 24 best identified patients according to follow-up clinical outcomes. Posttreatment PCS scores of 14 and 15 best identified patients with high follow-up pain intensity ratings and those who did not return to work, respectively. PCS reductions of approximately 38% to 44% were best associated with return to work and low pain intensity ratings at follow-up. Discussion: The results indicate scores on Catastrophizing before and after treatment that are clinically meaningful. These results may serve as preliminary guidelines to assess the clinical significance of interventions targeting pain Catastrophizing in patients with subacute pain after musculoskeletal injury.
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changes in pain Catastrophizing following physical therapy for musculoskeletal injury the influence of depressive and post traumatic stress symptoms
Journal of Occupational Rehabilitation, 2014Co-Authors: Peter Maxwell Slepian, Whitney Scott, Timothy H Wideman, Elena Bernier, Nils Georg Niederstrasser, Michael J L SullivanAbstract:Purpose: The aim of the present study was to investigate the factors that influence the change in pain Catastrophizing during the course of a physical therapy intervention for musculoskeletal injury. Methods: 187 clients enrolled in a 7-week physical therapy intervention were divided into four mutually exclusive groups on the basis of a pre-treatment assessment: (1) clients whose pre-treatment Catastrophizing scores and measures of mental health problems were below clinical threshold, (2) clients whose pre-treatment Catastrophizing scores were above clinical threshold but who scores on measures of mental health problems were below clinical threshold, (3) clients whose pre-treatment Catastrophizing scores were above clinical threshold and whose scores on measures of mental health problems were also above clinical threshold, and (4) clients whose pre-treatment Catastrophizing scores were below clinical threshold but whose scores on measures of mental health problems were above clinical threshold. Results: The most prevalent risk profile consisted of clients with high levels of pain Catastrophizing and high mental health problems (37 %), followed by the low Catastrophizing and low mental health problems profile (35 %), the high Catastrophizing and low mental health problems profile (16 %), and low Catastrophizing and high mental health problems profile (10 %). Clients were considered non-responders if their post-treatment Catastrophizing score remained above clinical threshold following treatment. Chi square analyses revealed a significantly higher proportion of non-responders in the high Catastrophizing and mental health problem group than in any other group. Conclusions: The presence of mental health symptoms markedly reduces the effectiveness of physical therapy for reducing Catastrophizing scores. The ‘risk value’ of high Catastrophizing scores thus appears to vary as a function of the presence or absence of mental health symptoms. The findings argue for the inclusion of measures of mental health problems in the routine screening of individuals treated in physical therapy.
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the role of presurgical expectancies in predicting pain and function one year following total knee arthroplasty
Pain, 2011Co-Authors: Michael J L Sullivan, Michael Tanzer, Gerald Reardon, David Amirault, Michael J Dunbar, William D StanishAbstract:The present study examined the prospective value of response expectancies (ie, pain, sleep) and behavioral outcome expectancies (ie, return to function) in the prediction of pain severity and functional limitations 12 months after total knee arthroplasty (TKA). The study sample consisted of 120 individuals (73 women, 47 men) with osteoarthritis of the knee who were scheduled for TKA. Measures of expectancies, pain severity, pain Catastrophizing, pain-related fears of movement, and depression were completed prior to surgery. Participants also completed measures of pain severity and functional limitations 12 months following surgery. Analyses revealed that behavioral outcome expectancies were stronger predictors of follow-up pain and functional limitations than response expectancies. Consistent with previous research, analyses also revealed that pain Catastrophizing, pain-related fear of movement, and depression predicted follow-up pain and function. In a multivariate analysis, only pain Catastrophizing contributed significant unique variance to the prediction of follow-up pain and function. Behavioral outcome expectancies partially mediated the relation between Catastrophizing and follow-up pain and function. The relation between Catastrophizing and follow-up pain severity and functional limitations remained significant even when controlling for behavioral outcome expectancies. The results suggest that interventions designed to specifically target behavioral outcome expectancies and Catastrophizing might improve post-surgical outcomes.
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a prospective sequential analysis of the fear avoidance model of pain
Pain, 2009Co-Authors: Timothy H Wideman, Heather Adams, Michael J L SullivanAbstract:Abstract The primary purpose of this study was to analyze the sequential relationships proposed by the fear-avoidance model of pain [Vlaeyen JWS et al. The role of fear of movement/(re)injury in pain disability. J Occup Rehab 1995;5:235–52]. Specifically, this study evaluated whether early change in Catastrophizing predicted late change in fear of movement, and whether these factors influenced post-treatment return-to-work. Secondary analyses tested relationships between (1) early change in Catastrophizing, late change in depression, and disability; and (2) early change in Catastrophizing, late change in pain severity, and disability. Analyses were conducted on a sample of 121 individuals (82 men and 32 women) with a work-related musculoskeletal injury, and high baseline Catastrophizing and fear of movement scores. Participants were enrolled in a 10-week community-based disability management intervention, and they completed measures of Catastrophizing, fear of movement, depression and pain severity at pre-, mid- and post-treatment. Return-to-work was assessed 4 weeks following termination of the intervention. Contrary to predictions, results from correlational analyses revealed non-significant relationships among indices of early change in Catastrophizing and late changes in fear of movement, depression and pain severity. Multiple logistic regression analyses revealed that early change in Catastrophizing, late changes in fear of movement and late change in pain severity were significant predictors of return-to-work, while late changes in depression were not. These findings highlight the importance of reductions in psychosocial risk factors in augmenting return-to-work outcomes. Implications for the fear-avoidance model and future research are discussed.
C Campbell - One of the best experts on this subject based on the ideXlab platform.
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disease related nondisease related and situational Catastrophizing in sickle cell disease and its relationship with pain
The Journal of Pain, 2016Co-Authors: Jennifer A Haythornthwaite, Robert R. Edwards, Vani A Mathur, Kasey B Kiley, Patrick C Carroll, Sophie Lanzkron, C CampbellAbstract:Abstract Catastrophizing is a potent psychological modulator of pain across several chronic pain populations; yet despite evidence that patients with sickle cell disease (SCD) catastrophize more than patients with other chronic pain conditions, previous research indicates that Catastrophizing is not related to sickle cell pain after controlling for relevant covariates such as depression. Recent research suggests that pain-related Catastrophizing should be assessed across pain contexts (eg, dispositional and situational). In this study, we measured disease-specific, general non-disease-related, and situational Catastrophizing and assessed the relationship between these contextual dimensions of Catastrophizing and laboratory and clinical pain among patients with SCD. Results revealed differential Catastrophizing across pain contexts, with patients reporting greater Catastrophizing about SCD-specific pain compared with non-SCD pain and laboratory pain. SCD-specific and non-SCD Catastrophizing were associated with clinical pain outcomes, and situational Catastrophizing with markers of central sensitization and laboratory pain. Further examination of the time course of laboratory responses revealed that increases in situational Catastrophizing were associated with subsequent increases in laboratory pain sensitivity. Taken together, results show the relevance of Catastrophizing in understanding pain in SCD, and suggest that context-specific anchors may be beneficial in predicting different aspects of the pain experience (eg, chronic pain, pain sensitization). Perspective Patients with SCD report greater Catastrophizing about sickle cell-specific pain relative to other pains. Disease-specific and non-disease-related pain Catastrophizing were associated with clinical pain, and situational Catastrophizing predictive of subsequent laboratory pain. Evaluation of context-specific Catastrophizing may more accurately predict different aspects of the pain experience.
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changes in pain Catastrophizing predict later changes in fibromyalgia clinical and experimental pain report cross lagged panel analyses of dispositional and situational Catastrophizing
Arthritis Research & Therapy, 2012Co-Authors: C Campbell, Robert R. Edwards, Mpepera Simango, Vani A Mathur, L Mccauley, S Bounds, Lora Conn, Kevin R FontaineAbstract: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. 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. 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. These findings provide empirical evidence that Catastrophizing processes might precede and contribute to subsequent alterations in the pain experience for FM patients. clinicaltrials.gov: NCT00383084 .
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situational versus dispositional measurement of Catastrophizing associations with pain responses in multiple samples
The Journal of Pain, 2010Co-Authors: C Campbell, Jennifer A Haythornthwaite, Robert R. Edwards, L Buenaver, Michael T Smith, Tarek Kronfli, Chantal BernaAbstract:Abstract Catastrophizing is widely recognized as an important risk factor for adverse pain-related outcomes. However, questions remain surrounding the details of its assessment. In particular, recent laboratory studies suggest that evaluation of “situational” Catastrophizing (ie, Catastrophizing measured during or directly after the administration of noxious stimulation) may provide information distinct from that obtained by standard, or “dispositional” measures, which assess individuals' recall of Catastrophizing in daily life. However, comparatively little research has systematically investigated the interrelationships and properties of these 2 different forms of pain-related Catastrophizing. The current study evaluated both situational and dispositional Catastrophizing measures within multiple samples: healthy individuals (N = 84), patients with painful temporomandibular joint disorders (TMD; N = 48), and patients with painful arthritis (N = 43). All participants first completed the Pain Catastrophizing Scale (PCS), and then underwent psychophysical pain testing, which included heat, cold, and pressure pain. Participants then completed a situational Catastrophizing measure with reference to the laboratory pain he/she had just undergone. Situational Catastrophizing scores were not significantly correlated with dispositional PCS scores in the healthy participants and arthritis patients, though they were associated in TMD patients. Situational Catastrophizing was more strongly associated with experimental pain responses than dispositional PCS scores for the healthy subjects and arthritis patients. In general, higher levels of situational Catastrophizing were associated with lower pain thresholds and higher pain ratings across all 3 samples. The findings highlight the importance of multidimensional assessment of pain-related Catastrophizing, and suggests a role for measuring Catastrophizing related to specific, definable events. Perspective This study adds to a growing literature examining Catastrophizing. Our findings highlight the potential importance of the multidimensional assessment of pain-related Catastrophizing, and suggest a role for measuring Catastrophizing related to specific, definable events.
