Assessment of Chronic Pain Patients
Andrea Kohn Maikovich-Fong in Handbook of Psychosocial Interventions for Chronic Pain, 2019
A large body of evidence suggests that catastrophizing plays a significant role in the pain experience. Catastrophizing is a cognitive process in which a person assumes the worst possible outcome, perseverates on this, and interprets minor problems as major disasters (Turk et al., 2016). This pattern of thinking can lead to the development of more passive styles of coping, such as rumination and helplessness, and thereby exacerbate the pain. This pattern has been associated with greater emotional distress and disability. One imaging study of patients with fibromyalgia showed that catastrophizing (independent of depression) was associated with pain-related activation in the brain areas that reflect attentional, anticipatory, and emotional responses to pain (Gracely et al., 2004). Another study reported that catastrophizing, when compared with baseline physical measures, was more predictive of onset of back pain and disability (Jarvik et al., 2005). Catastrophizing also has been identified as a significant predictor of pain-related disability in chronic pain patients (Arnow et al., 2011).
Cognitive-Behavioral Group Therapy for Multiple-DUI Offenders
Stephen K. Valle in Drunk Driving in America: Strategies and Approaches to Treatment, 2013
The idea of catastrophizing was described as the process of exaggeration of consequences and the development of a negative mind set (e.g., one thinks of all the possible negative things that could happen in a situation until he or she creates a belief that some outcome would be terrible or awful). As clients identified the “shoulds” and catastrophizing leading to negative emotions, they were solicited for what they did when these emotions occurred (including abusive drinking). Group members were encouraged to change the underlying thoughts and beliefs to prevent excessive drinking in response to unrealistic beliefs and negative feelings. Homework required the clients to record situations in which they noticed “shoulds” or catastrophizing during the upcoming week and to consider alternative ways of thinking.
Psychological aspects of preparation for painful procedures
Harald Breivik, William I Campbell, Michael K Nicholas in Clinical Pain Management, 2008
Examples of items used in checklists for indicating worries are shown in Figure 22.1a,b. Johnston’s 1987 25-item checklist4 was developed both from items used in the literature and patients’ spontaneous comments. These checklists assess what people are worried about, but not whether they catastrophize, exaggerating the risks of negative outcomes. Recent work using the Pain Catastro-phizing Scale11 has found that people who catastrophize about pain before undergoing surgical procedures experience worse postoperative pain.12,13 However, neither paper investigated catastrophizing independently of general anxiety, so general anticipation of negative outcomes could be responsible for this effect. Further research controlling for the effects of general anxiety is therefore necessary.
Pain, Pain Catastrophizing, and Individual Differences in Executive Function in Adolescence
Published in Children's Health Care, 2019
Tyler Bell, Jessica H. Mirman, Despina Stavrinos
Over the last two decades, one of the best predictors of pain difficulty and chronicity is pain catastrophizing. Catastrophizing is formally defined as a maladaptive coping strategy involving “an exaggerated negative mental set brought to bear during actual or anticipated painful experience” (Sullivan et al., 2001). This coping style involves rumination and magnification of pain along with feelings of helplessness, which have been shown to underlie pain intensity reported by various pain conditions. For example, in cross-sectional studies, higher catastrophizing predicts higher pain intensity in persons with acute (Suren et al., 2014) and chronic pain (Esteve, Ramirez-Maestre, & Lopez-Marinez, 2007). Prospectively, studies also show that a pattern of catastrophic thinking precedes the development of intense pain after painful events such as major surgery (Pavlin, Sullivan, Freund, & Roesen, 2005) and the commencement of chronic pain disorders from acute injury (Buer & Linton, 2002). Thus, catastrophizing appears as an important antecedent for pain difficulty and can be used to identify individuals at risk for pain development (Edwards, 2005).
Telephone-Based Versus In-Person Delivery of Cognitive Behavioral Treatment for Veterans with Chronic Multisymptom Illness: A Controlled, Randomized Trial
Published in Military Behavioral Health, 2018
Lisa M. McAndrew, Lauren M. Greenberg, Donald S. Ciccone, Drew A. Helmer, Helena K. Chandler
The current study tested a cognitive behavioral treatment for stress reduction that addressed patient's cognitive and emotional responses to CMI, particularly catastrophizing. Catastrophizing is a cognitive response style of having exaggerated thoughts in response to pain and physical symptoms such as “this pain will kill me” or “I cannot stand it anymore” (Keefe et al., 2000; Minton, Richardson, Sharpe, Hotopf, & Stone, 2010; M. J. Sullivan et al., 2001; Theunissen, Peters, Bruce, Gramke, & Marcus, 2012; Turner, Jensen, & Romano, 2000). Reductions in catastrophizing are a strong predictor of reduced psychological stress for civilians with chronic pain (Spinhoven et al., 2004; Thorn et al., 2007; Turner, Holtzman, & Mancl, 2007). The current study compared usual care to telephone delivered cognitive behavioral treatment for stress reduction to in-person delivered cognitive behavioral treatment for stress reduction. The cognitive behavioral treatment was delivered both over the telephone and in person because chronic symptoms may make it difficult to access healthcare. The primary dependent variable for this analysis was the role-physical subscale of the SF-36 which captures limitations in the ability to engage in work and home roles. Secondary outcomes include the physical function subscale of the SF-36 which captures perceived ability to be physically active, PTSD symptoms, depressive symptoms and physical symptoms.
Treating osteoarthritis pain: mechanisms of action of acetaminophen, nonsteroidal anti-inflammatory drugs, opioids, and nerve growth factor antibodies
Published in Postgraduate Medicine, 2021
Yvonne D’Arcy, Patrick Mantyh, Tony Yaksh, Sean Donevan, Jerry Hall, Mojgan Sadrarhami, Lars Viktrup
Overall, persistent neuronal sensitization, and possibly peripheral sprouting, enhance pain responses in terms of intensity and duration, resulting in a chronically altered afferent pain signaling characterized by allodynia and/or hyperalgesia that may persist even when inflammation subsides to low-grade. Though a detailed discussion is beyond the scope of this review, it should be noted that chronic pain is often associated with changes in the sympathetic nervous system and sympathetic activity likely contributes to the overall chronic pain experience [38]. The overall chronic pain experience is also affected by, and can affect, a variety of factors including genetic predisposition, patient comorbidities, previous pain experience, mood, emotional distress, coping ability, and other psychosocial or sociocultural factors [39,40]. Thus, the chronic pain experience may differ between patients even when the etiology is similar. Catastrophizing, for example, can lead to psychosomatic or stress-related symptoms that may exacerbate perception of chronic pain [39,41]. Catastrophizing encompasses helplessness (i.e. nothing will change the pain), negative amplification of pain-related thoughts through rumination (i.e. repetitive thoughts about pain), and magnification (i.e. exaggerated concern about negative consequences of pain) [39]. Catastrophizing can also lead to secondary complications such as fear, irritability, anxiety, inability to cope, sleep impairment, depression, suicidal ideation, and overall diminished quality of life [42-44].
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