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Pain Catastrophizing Differs Between and Within West Haven-Yale Multidimensonal Pain Inventory (MPI) Pain Adjustment Classifications: Theoretical and Clinical Implications From Preliminary Data

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

doi: 10.1097/AJP.0000000000000117
Original Articles

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

Materials and Methods: Sixty-nine adults (70% women) diagnosed with musculoskeletal pain were recruited from 2 pain clinics and completed self-report measures of pain severity, the MPI, 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 with 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 (Ps<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.

*Department of Behavioral Sciences, University of Michigan, Dearborn, MI

Department of Psychology, Salisbury University, Salisbury, MD

This project was partially supported with a faculty research Grant (U028074) from the University of Michigan, Dearborn, MI. The authors declare no conflict of interest.

Reprints: David K. Chatkoff, PhD, Department of Behavioral Sciences, University of Michigan, 4901 Evergreen Rd, 4050 CASL Building, Dearborn, MI 48128 (e-mail:

Received June 26, 2013

Received in revised form May 23, 2014

Accepted April 28, 2014

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