The role of pain catastrophizing in eliciting pain, distress, and suicidality among chronic pain patients

Abstract

Background: Successful management of chronic pain entails daily use of coping strategies.The goal of these two studies was to examine the role of pain catastrophizing and acceptance in predicting pain, disability, distress, and suicidality. Methods: Study 1 428 chronic pain patients treated at two outpatient pain specialty pain clinics completed a battery of self-report measures examining pain catastrophizing, depression, anxiety, pain, and pain related disability in four assessment waves (mean interval =7 months). In order to test the longitudinal effects, we used structural equation modeling (SEM) and averaged participants' times 2-4 to create a new two wave model. Study 2 166 patients completed measures including coping, pain acceptance, pain, depression, hope, interpersonal predictors of suicidality, and suicide ideation. Stepwise Logistic Regression was used to predict suicide ideations and multiple regression analyses for other outcomes. Results: Study 1 Time 1 Pain catastrophizing only predicted pain in Time 2 (β =.36, CR = 3.66, p < .001). Study 2 Depression, sense of burdensomeness, and pain catastrophizing predicted suicide ideations (O.R.= 1.10, 1.31 and 1.88 accordingly. Pain catastrophizing and distraction predicted sensory pain (β = .22, t = 2.38, p =.02 and β = .21, t = 2.42, p =.02 accordingly). Pain catastrophizing and life engagement predicted depression (β = .43, t = 5.93, p <.000, and β = -.29, t = -3.58, p <.001 accordingly). Conclusions: Pain catastrophizing might constitute a substantial risk factor for multiple psychiatric symptoms in chronic pain. Acceptance may serve as a resilience factor for depression in pain.