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Mind-body interactions in pain: the neurophysiology of anxious and catastrophic pain-related thoughts
Open accessAbstract
The well-accepted biopsychosocial model proposes that the experience of pain and responses to it result from a complex interaction of biological, psychological, and social factors. However, the separation of these constructs is substantially artificial, and we presume that psychological processes have biological effects, that biological processes affect an individual's psychosocial environment, and so on. Considerable research has demonstrated that pain-coping strategies influence perceived pain intensity and physical functioning, and individual differences in styles of pain coping even shape the persistence of long-term pain complaints in some populations. A good deal of this coping research has focused on catastrophizing, which is a generally maladaptive cognitive and emotional mental set that involves feelings of helplessness when in pain, rumination about pain symptoms, and magnification of pain-related complaints. Collectively, catastrophizing has been consistently associated with heightened experiences of pain across a variety of samples. Although catastrophic thinking regarding pain-related symptoms is often classified under the "psychologic" category within the broader biopsychosocial model, we propose that catastrophizing exerts biologic effects that may account for some of its negative consequences. In general, the cognitive and affective processes captured within the construct of catastrophizing may exert effects on the neuromuscular, cardiovascular, immune, and neuroendocrine systems, and on the activity in the pain neuromatrix within the brain. The interface between pain-related neurobiology and processes such as pain-related catastrophizing represents an important avenue for future pain research.
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“Additionally, catastrophizing has been linked to increased hypervigilance and heightened activity in brain regions involved in threat detection and affective processing.45,46”
From Acceptance and commitment therapy for prevention of chronic pain after total knee arthroplasty. (2026) · cites this paper as [45]
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Metadata
- Authors
- Campbell, C. M., & Edwards, R. R.
- Affiliations
- Johns Hopkins University (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Edwards, Robert R.
- Venue
- Translational research
- Publisher
- Elsevier BV
- Published
- 2009-03
- Volume
- 153
- Issue
- 3
- Pages
- 97-101
- ISSN
- 1878-1810 (ISSN-L)
- 1931-5244
- PMC
- PMC2738609
- OpenAlex
- W2057603114
- Cited by
- 175
- References
- 42
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 7 · 2023: 13 · 2022: 6 · 2021: 8 · 2020: 9 · 2019: 9 · 2018: 9 · 2017: 11 · 2016: 11 · 2015: 12 · 2014: 14 · 2013: 13 · 2012: 11
- FWCI
- 1.28
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Translational research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (7k23ar051315-05)
- National Institute of Neurological Disorders and Stroke (F32NS063624)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (K23-AR051315)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Keywords
- pain catastrophizing, mind-body problem, biopsychosocial model, pain coping, pain perception, rumination, helplessness
- MeSH terms
- Anxiety, Humans, Inflammation, Nervous System Physiological Phenomena, Pain, Psychophysiology, Thinking
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