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Catastrophizing is associated with pain intensity, psychological distress, and pain-related disability among individuals with chronic pain after spinal cord injury
Abstract
Little research has examined the role of patient cognitive and behavioral responses, including catastrophizing, in adjustment to chronic pain associated with spinal cord injury (SCI). The objective of this study was to examine the associations of catastrophizing and specific pain coping strategies with pain intensity, psychological distress, and pain-related disability among individuals with chronic pain and SCI, after controlling for important demographic and SCI-related variables that might affect outcomes. Participants in this study were 174 community residents with SCI and chronic pain who completed a mailed questionnaire that included the SF-36 Mental Health scale, Coping Strategies Questionnaire, and Graded Chronic Pain Scale. The pain coping and catastrophizing measures explained an additional 29% of the variance in pain intensity after adjusting for the demographic and SCI variables (P<0.001). The coping and catastrophizing scales accounted for an additional 30% of the variance in psychological distress (P<0.001) and 11% of the variance in pain-related disability (P<0.001), after controlling for pain intensity and demographic and SCI variables. Catastrophizing, but not any other single pain coping strategy, was consistently strongly and independently associated with the outcome measures. Potentially, the assessment and treatment of catastrophizing may reduce psychological distress and pain-related disability among individuals with chronic pain and SCI.
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“Catastrophizing beliefs have been shown to intensify the perceived pain intensity, pain-related disability and psychological distress [23,24], thus being an important mechanism of change in psychological therapies [25].”
In the citing paper
“Data analyses showed that individuals who engaged in higher levels of pain catastrophizing had significantly higher levels of psychological distress and pain-related disability.”
From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [135]
In the citing paper
“Data analyses showed that individuals who engaged in higher levels of pain catastrophizing had significantly higher levels of psychological distress and pain-related disability.”
From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [135]
In the citing paper
“Taken together, the findings of these studies suggest that catastrophizing is important in understanding pain, not only in samples of patients seen in medical settings but also in samples of individuals recruited from the general community.104,135”
From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [135]
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“…also suggests that several of these factors are associated with pain and adjustment to pain in persons with pain secondary to a physical disability (e.g., spinal cord injury, amputation, and cerebral palsy) (cf. Engel et al., 2000; Jensen et al., 2002; Turner et al., 2002; Hanley et al., 2004).”
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Jensen, M. P., Kuehn, C. M., Amtmann, D., & Cardenas, D. D. (2007) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2007.02.002 · Cited by 176
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“A large body of literature has consistently revealed that pain catastrophizing is related to higher psychological distress, pain ratings, and functional disability (18,19).”
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“Pain catastrophizing is associated with disability and higher pain intensity both in pain patients (36,37) and in the general population (38,39).”
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Tan, G., Teo, I., Anderson, K. O., & Jensen, M. P. (2011) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e31821d8f5a · Cited by 75
Pain catastrophizing predicts poor response to topical analgesics in patients with neuropathic pain
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“Recent studies have examined the relationship between pain catastrophizing and pain experience in individuals suffering from neuropathic pain conditions (10).”
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Chronic Pain in Persons with Multiple Sclerosis
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BackgroundPain Catastrophizing and Pain-related Emotions
Ruscheweyh, R., Nees, F., Marziniak, M., Evers, S., Flor, H., & Knecht, S. (2011) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e31820fde1b · Cited by 71
Plasma corticosterone levels in mouse models of pain
Benedetti, M., Merino, R., Kusuda, R., Ravanelli, M. I. B., Cadetti, F., Santos, P., Zanon, S., & Lucas, G. (2011) · European Journal of Pain · doi:10.1002/j.1532-2149.2011.00066.x · Cited by 70
“Clinical observations also suggest that stress increases susceptibility to develop pain and aggravates existing pain (Ashkinazi and Vershinina, 1999; Turner et al., 2002).”
BackgroundFelix, E. R., Cruz‐Almeida, Y., & Widerström-Noga, E. G. (2007) · The Journal of Rehabilitation Research and Development · doi:10.1682/jrrd.2006.12.0162 · Cited by 70
Clinical Assessment Following Acute Cervical Spinal Cord Injury
Hadley, M. N., Walters, B. C., Aarabi, B., Dhall, S. S., Gelb, D. E., Hurlbert, R. J., Rozzelle, C. J., Ryken, T. C., & Theodore, N. (2013) · Neurosurgery · doi:10.1227/neu.0b013e318276edda · Cited by 70
“There are a variety of psychological and psychosocial factors that interface with the pain of SCI origin that influence its management and treatment.(74,76,80-83) The importance of pain symptoms to patients with SCI cannot be understated.”
BackgroundMolton, I. R., Stoelb, B. L., Jensen, M. P., Ehde, D. M., Raichle, K. A., & Cardenas, D. D. (2009) · The Journal of Rehabilitation Research and Development · doi:10.1682/jrrd.2008.03.0044 · Cited by 71
“, greater pain intensity, disability, and psychological distress), even when controlling for level of physical impairment and other painrelated variables [25–27].”
BackgroundSüren, M., Okan, İ., Gökbakan, A. M., Ziya, K. A. Y. A., Erkorkmaz, Ü., Arıcı, S., Karaman, S., & Kahveci, M. (2013) · TURKISH JOURNAL OF MEDICAL SCIENCES · doi:10.3906/sag-1206-67 · Cited by 69
“cord damage tended to catastrophize significantly more than male patients (19).”
BackgroundValidation of the Pain-Related Catastrophizing Thoughts Scale
Sardá, J., Nicholas, M. K., Pereira, I. A., Pimenta, C. A. D. M., Asghari, A., & Cruz, R. M. (2008) · Acta Fisiátrica · doi:10.5935/0104-7795.20080001 · Cited by 70
Nieto, R., Raichle, K. A., Jensen, M. P., & Miró, J. (2011) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e31822019b1 · Cited by 69
The importance of psychological assessment in chronic pain
Williams, D. A. (2013) · Current Opinion in Urology · doi:10.1097/mou.0b013e3283652af1 · Cited by 65
Lerch, J. K., Puga, D. A., Bloom, O., & Popovich, P. G. (2014) · Seminars in Immunology · doi:10.1016/j.smim.2014.03.004 · Cited by 56
Abbreviated psychologic questionnaires are valid in patients with hand conditions
Bot, A. G. J., Becker, S. J. E., van Dijk, N. C., Ring, D., & Vranceanu, A.-M. (2013) · Clinical Orthopaedics & Related Research · doi:10.1007/s11999-013-3213-2 · Cited by 55
“Previous studies established the value of the DASH, PCS, PHQ, and SHAI questionnaires in hand surgery [1, 19–21, 27, 28, 32].”
MethodMiró, J., Raichle, K. A., Carter, G. T., O'Brien, S. A., Abresch, R. T., McDonald, C. M., & Jensen, M. P. (2009) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/1049909109335146 · Cited by 55
“The CSQ scale has evidenced excellent internal consistency reliability(31-35) and the validity of the CSQ is supported by its correlation with depression and adjustment.(23,36-40) Mean, standard deviation, and Cronbach’s a values of the CSQ Catastrophizing scale are reported in Table 1.”
MethodNewman, A. K., Dyke, B. P. V., Torres, C. A., Baxter, J. W., Eyer, J. C., Kapoor, S., & Thorn, B. E. (2017) · Pain · doi:10.1097/j.pain.0000000000000964 · Cited by 55
“Research has consistently demonstrated strong relationships among pain catastrophizing, depression, and chronic pain.(68,71,74,76) There is a well-documented comorbidity between chronic pain and depression,(47,49,78) and pain catastrophizing is a robust predictor of greater pain severity, poorer overall functioning, a…”
BackgroundBiopsychosocial Correlates of Headache: What Predicts Pediatric Headache Occurrence?
Kröner‐Herwig, B., Morris, L., & Heinrich, M. (2007) · Headache The Journal of Head and Face Pain · doi:10.1111/j.1526-4610.2007.00945.x · Cited by 54
Głowacka, M. D., Rosen, N. O., Chorney, J. M. L., Snelgrove‐Clarke, E., & George, R. B. (2014) · The Journal of Sexual Medicine · doi:10.1111/jsm.12675 · Cited by 52
Gustin, S. M., Wilcox, S. L., Peck, C. C., Murray, G. M., & Henderson, L. A. (2011) · Pain · doi:10.1016/j.pain.2010.12.033 · Cited by 53
Campbell, C. M., Quartana, P. J., Buenaver, L. F., Haythornthwaite, J. A., & Edwards, R. R. (2010) · Journal of Pain · doi:10.1016/j.jpain.2009.12.007 · Cited by 57
Pain during mammography: the role of coping strategies
Asghari, A., & Nicholas, M. K. (2004) · Pain · doi:10.1016/j.pain.2003.12.022 · Cited by 53
“However, other studies with chronic pain patients have not reported significant associations between coping self-statements and pain intensity (e.g. Beckham et al., 1991; Keefe et al., 1990; Turner et al., 2002).”
BackgroundFurther validation of the chronic pain coping inventory
Tan, G., Nguyen, Q., Anderson, K. O., Jensen, M., & Thornby, J. (2005) · The Journal of Pain · doi:10.1016/j.jpain.2004.09.006 · Cited by 51
Self-citationPang, M., Eng, J., Lin, K.-H., Tang, P., Hung, C., & Wang, Y.-H. (2009) · Journal of Rehabilitation Medicine · doi:10.2340/16501977-0455 · Cited by 54
Trost, Z., & Parsons, T. D. (2014) · Journal of Applied Biobehavioral Research · doi:10.1111/jabr.12021 · Cited by 50
“These include conditions such as spinal cord injury (Turner et al., 2002), fibromyalgia (Martinez et al., 2011), and osteoarthritis (Heuts et al., 2004; Somers et al., 2009) as well as outcomes following medical and surgical interventions such as total knee replacement (Sullivan et al., 2009).”
BackgroundTan, G., Nguyen, Q., Cardin, S. A., & Jensen, M. P. (2006) · Journal of Pain · doi:10.1016/j.jpain.2005.11.007 · Cited by 50
Pain Catastrophizing Scale for Francophone Adolescents: A Preliminary Validation
Tremblay, I., Beaulieu, Y., Bernier, A., Crombez, G., Laliberté, S., Thibault, P., Velly, A. M., & Sullivan, M. J. L. (2008) · Pain Research and Management · doi:10.1155/2008/845674 · Cited by 53
Lerch, J. K., Alexander, J., Madalena, K. M., Motti, D., Quach, T., Dhamija, A., Zha, A. M., Gensel, J. C., Marketon, J. I. W., Lemmon, V., et al. (2017) · eNeuro · doi:10.1523/eneuro.0246-17.2017 · Cited by 50
“Stress can also elicit or exacerbate pain in human disease (Ashkinazi and Vershinina, 1999; Turner et al., 2002; Greco et al., 2004; Nicholson and Martelli, 2004; DeLeo, 2006).”
BackgroundMcKnight, P. E., Afram, A., Kashdan, T. B., Kasle, S., & Zautra, A. (2010) · Journal of Behavioral Medicine · doi:10.1007/s10865-010-9252-1 · Cited by 50
“For example, transient pain symptoms may affect catastrophizing less (Turner et al. 2004) than self-efficacy (Smarr et al. 1997).”
BackgroundThe pain self-efficacy questionnaire: validation of an abbreviated two-item questionnaire.
Briet, J. P., Bot, A. G., Hageman, M., Menendez, M. E., Mudgal, C., & Ring, D. (2014) · Psychosomatics · doi:10.1016/j.psym.2014.02.011 · Cited by 44
“Psychosocial factors such as low pain selfefficacy and greater symptoms of depression are consistent and strong predictors of upper extremity specific disability (4-10).”
BackgroundThe role of psychological variables in explaining depression in older people with chronic pain
López‐López, A., Montorio, I., Izal, M., & Furlong, L. V. (2008) · Aging & Mental Health · doi:10.1080/13607860802154408 · Cited by 46
“, 2000) and greater psychological distress (Turner et al., 2002), though the results were inconclusive.”
BackgroundResultInfluentialCheatle, M. D. (2014) · Pain Physician · doi:10.36076/ppj.2014/17/e359 · Cited by 45
López‐de‐Uralde‐Villanueva, I., Beltrán-Alacreu, H., Fernández‐Carnero, J., & Touche, R. L. (2018) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2018.1480678 · Cited by 46
Endler, N. S., Corace, K. M., Summerfeldt, L. J., Johnson, J. M., & Rothbart, P. (2002) · Personality and Individual Differences · doi:10.1016/s0191-8869(02)00048-x · Cited by 45
Catastrophizing, pain, and pain interference in individuals with disabilities
Hirsh, A. T., Bockow, T. B., & Jensen, M. P. (2011) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/phm.0b013e31822409b2 · Cited by 45
Self-citationvan Laake‐Geelen, C. C. M., Kindermans, H. P. J., van den Bergh, J. P., & Verbunt, J. (2016) · Pain Practice · doi:10.1111/papr.12449 · Cited by 45
Metadata
- Authors
- Turner, J. A., Jensen, M. P., Warms, C. A., & Cardenas, D. D.
- Affiliations
- University of Washington (US)
- Corresponding author
- Turner, Judith A.
- Venue
- Pain
- Published
- 2002-07
- Volume
- 98
- Issue
- 1
- Pages
- 127-134
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2082192971
- Cited by
- 333
- References
- 45
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 6 · 2023: 11 · 2022: 7 · 2021: 13 · 2020: 8 · 2019: 18 · 2018: 13 · 2017: 19 · 2016: 21 · 2015: 19 · 2014: 18 · 2013: 20 · 2012: 12
- FWCI
- 5.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (1P01 HD/NS33988)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Clinical Neurology › Spinal Cord Injury Research
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- catastrophizing, chronic pain, spinal cord injury, pain coping, pain intensity, psychological distress, pain-related disability
- MeSH terms
- Adaptation, Psychological, Adult, Aged, Mental Disorders, Chronic Disease, Female, Persons with Disabilities, Humans, Male, Middle Aged, Pain, Pain Measurement, Severity of Illness Index, Spinal Cord Injuries
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