Pain catastrophizing: a critical review

Abstract

Pain catastrophizing is conceptualized as a negative cognitive–affective response to anticipated or actual pain and has been associated with a number of important pain-related outcomes. In the present review, we first focus our efforts on the conceptualization of pain catastrophizing, highlighting its conceptual history and potential problem areas. We then focus our discussion on a number of theoretical mechanisms of action: appraisal theory, attention bias/information processing, communal coping, CNS pain processing mechanisms, psychophysiological pathways and neural pathways. We then offer evidence to suggest that pain catastrophizing represents an important process factor in pain treatment. We conclude by offering what we believe represents an integrated heuristic model for use by researchers over the next 5 years; a model we believe will advance the field most expediently.

Keywords::

• attention bias
• chronic pain
• communal coping
• fMRI
• helplessness
• pain catastrophizing
• pain-related surgery
• pain sensitivity
• primary/secondary appraisal

Financial & competing interests disclosure

Phil Quartana is funded by an NIH Training Grant (T32MH075884), Claudia Campbell is funded by an NIH grant (F32NS063624) and Robert Edwards is also funded by an NIH grant (K23AR051315). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.