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Clinical Journal of Pain:
doi: 10.1097/AJP.0000000000000117
Original Article: PDF Only

Pain Catastrophizing Differs Between and Within Whympi Pain Adjustment Classifications: Theoretical and Clinical Implications from Preliminary Data.

Chatkoff, David K. PhD; Leonard, Michelle T. PhD; Maier, Karl J. PhD

Published Ahead-of-Print
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Abstract

Objectives: Pain catastrophizing is associated with multiple pain outcomes, and is differentially associated with the adaptive (AC), dysfunctional(DYS), and interpersonally distressed (ID) coping classifications of the West Haven-Yale Multidimensional Pain Inventory (WHYMPI). We examined how catastrophizing, and the underlying components of magnification, rumination, and helplessness, may relate to WHYMPI classifications and differentially relate to pain outcomes across classification groups to inform clinical treatment planning.

Methods: Sixty nine adults (70% women) diagnosed with musculoskeletal pain were recruited from two pain clinics and completed self-report measures of pain severity, the WHYMPI, Pain Catastrophizing Scale, and the Mood and Anxiety Symptom Questionnaire.

Results: Patients in the DYS and ID groups reported the greatest levels of rumination, helplessness, and overall catastrophizing, as well as the greatest depression, anxiety, and pain interference compared to the AC group. Catastrophizing related to average pain only in the DYS group (P <0.05), however, catastrophizing was associated with depression, anxiety, and interference (P's <0.05) among those in the AC group, with a similar pattern observed among the ID group.

Discussion: Our findings suggest a continued need for targeting catastrophizing and negative affect among pain patients. However, our data suggest that even among relatively well adjusted patients, there may be clinical utility in assessing catastrophic thinking given the associations of it with pain-related outcomes. The present findings additionally support the value of enlisting multiple theoretical perspectives such as the stress appraisal and attentional models in future research and clinical applications.

(C) 2014 by Lippincott Williams & Wilkins

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