Coping with rheumatoid arthritis pain: catastrophizing as a maladaptive strategy
Abstract
The present study examined catastrophizing in rheumatoid arthritis (RA) patients. Subjects were 223 RA patients who were participants in a longitudinal study. Each patient completed the Catastrophizing scale of the Coping Strategies Questionnaire (CSQ) on 2 occasions separated by 6 months (time 1, time 2). The Catastrophizing scale is designed to measure negative self-statements, castastrophizing thoughts and ideation (sample items = 'I worry all the time about whether it will end,' 'It is awful and I feel that it overwhelms me'). Data analysis revealed that the Catastrophizing scale was internally reliable (alpha = 0.91) and had high test-retest reliability (r = 0.81) over a 6 month period. Correlational analyses revealed that catastrophizing recorded at time 1 was related to pain intensity ratings, functional impairment on the Arthritis Impact Measurement scale (AIMS), and depression at time 2. Predictive findings regarding catastrophizing while modest were obtained after controlling for initial scores on the dependent variables, demographic variables (age, sex, socioeconomic status), duration of pain, and disability support status. Taken together, these findings suggest that catastrophizing is a maladaptive coping strategy in RA patients. Further research is needed to determine whether cognitive-behavioral interventions designed to decrease catastrophizing can reduce pain and improve the physical and psychological functioning of RA patients.
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A consistent relation between pain catastrophising and distress reactions to painful stimulation has been demonstrated.
“a consistent relation between PC and distress reactions to painful stimulation has been demonstrated [3]”
From Effectiveness of cognitive behaviour therapy for the treatment of catastrophisation in patients with fibromyalgia: A randomised controlled trial (2011) · cites this paper as [3]
Pain catastrophising is associated with reduced involvement in daily activities.
“reduced involvement in daily activities [3]”
From Effectiveness of cognitive behaviour therapy for the treatment of catastrophisation in patients with fibromyalgia: A randomised controlled trial (2011) · cites this paper as [3]
A consistent relation between catastrophizing and distress reactions to painful stimulation has been demonstrated.
“The role of catastrophizing in mediating responses to pain has received considerable attention in recent years [1-3] and a consistent relation between catastrophizing and distress reactions to painful stimulation has been demonstrated [3].”
From Effectiveness of the psychological and pharmacological treatment of catastrophization in patients with fibromyalgia: a randomized controlled trial. (2009) · cites this paper as [3]
Pain catastrophizing has been associated with reduced involvement in daily activities.
“Some of the consequences that have been associated with pain catastrophizing are more intense pain [6], heightened pain behaviour [7-9], greater analgesic consumption [10,11], reduced involvement in daily activities [3], occupational disability [12-14] and suicidal ideation [15].”
From Effectiveness of the psychological and pharmacological treatment of catastrophization in patients with fibromyalgia: a randomized controlled trial. (2009) · cites this paper as [3]
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“Theroleofcatastrophizinginmediatingresponsestopainhas received considerable attention in recent years [1-3] and a consistent relation between catastrophizing and distress reactions to painful stimulation has been demonstrated [ 3 ].”
BackgroundInfluentialRole of pain-based catastrophizing in pain, disability, distress, and suicidal ideation
Noyman-Veksler, G., Lerman, S. F., Joiner, T. E., Brill, S., Rudich, Z., Shalev, H., & Shahar, G. (2017) · Psychiatry · doi:10.1080/00332747.2016.1230984 · Cited by 28 · see citing works
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Pain catastrophizing: an historical perspective
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“Other studies indicate that catastrophizing is a separate construct from depression (Keefe et al., 1989; Sullivan et al., 1995, 2001).”
Background
- Authors
- Keefe, F. J., Brown, G. K., Wallston, K. A., & Caldwell, D. S.
- Affiliations
- Vanderbilt University (US)
- University of Pennsylvania (US)
- Duke Medical Center (US)
- Corresponding author
- Keefe, Francis J.
- Caldwell, David S.
- Venue
- Pain
- Published
- 1989-04
- Volume
- 37
- Issue
- 1
- Pages
- 51-56
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2039883270
- Cited by
- 694
- References
- 20
- Citations by year
- 2026: 3 · 2025: 13 · 2024: 11 · 2023: 9 · 2022: 14 · 2021: 14 · 2020: 15 · 2019: 20 · 2018: 25 · 2017: 20 · 2016: 30 · 2015: 21 · 2014: 18 · 2013: 23 · 2012: 25
- FWCI
- 12.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01nr001007-10)
- National Institute of Nursing Research (5 R01 NR 1007)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Keywords
- rheumatoid arthritis, pain catastrophizing, maladaptive coping, pain intensity, functional disability, depression, Coping Strategies Questionnaire, cognitive-behavioral intervention, psychosocial functioning
- MeSH terms
- Adult, Aged, Arthritis, Rheumatoid, Chronic Disease, Female, Humans, Longitudinal Studies, Male, Middle Aged, Pain
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