The Pain Catastrophizing Scale: Development and validation.
01 Jan 1995-Psychological Assessment (American Psychological Association)-Vol. 7, Iss: 4, pp 524-532
TL;DR: In this paper, the Pain Catastrophizing Scale (PCS) was administered to 425 undergraduates and a three component solution comprising (a) rumination, (b) magnification, and (c) helplessness.
Abstract: In Study 1, the Pain Catastrophizing Scale (PCS) was administered to 425 undergraduates. Analyses yielded a three component solution comprising (a) rumination, (b) magnification, and (c) helplessness. In Study 2, 30 undergraduate participants were classified as catastrophizers (n = 15) or noncatastrophizers (n = 15) on the basis of their PCS scores and participated in an cold pressor procedure. Catastrophizers reported significantly more negative pain-related thoughts, greater emotional distress, and greater pain intensity than noncatastrophizers. Study 3 examined the relation between PCS scores, negative pain-related thoughts, and distress in 28 individuals undergoing an aversive electrodiagnostic medical procedure. Catastrophizers reported more negative pain-related thoughts, more emotional distress, and more pain than noncatastrophizers. Study 4 examined the relation between the PCS and measures of depression, trait anxiety, negative affectivity, and fear of pain. Analyses revealed moderate correlations among these measures, but only the PCS contributed significant unique variance t o the prediction of pain intensity.
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TL;DR: In this article, the authors reviewed the existing evidence for the mediating role of pain-related fear, and its immediate and long-term consequences in the initiation and maintenance of chronic pain disability.
Abstract: In an attempt to explain how and why some individuals with musculoskeletal pain develop a chronic pain syndrome, Lethem et al. (Lethem J, Slade PD, Troup JDG, Bentley G. Outline of fear-avoidance model of exaggerated pain perceptions. Behav Res Ther 1983; 21: 401-408).ntroduced a so-called 'fear-avoidance' model. The central concept of their model is fear of pain. 'Confrontation' and 'avoidance' are postulated as the two extreme responses to this fear, of which the former leads to the reduction of fear over time. The latter, however, leads to the maintenance or exacerbation of fear, possibly generating a phobic state. In the last decade, an increasing number of investigations have corroborated and refined the fear-avoidance model. The aim of this paper is to review the existing evidence for the mediating role of pain-related fear, and its immediate and long-term consequences in the initiation and maintenance of chronic pain disability. We first highlight possible precursors of pain-related fear including the role negative appraisal of internal and external stimuli, negative affectivity and anxiety sensitivity may play. Subsequently, a number of fear-related processes will be discussed including escape and avoidance behaviors resulting in poor behavioral performance, hypervigilance to internal and external illness information, muscular reactivity, and physical disuse in terms of deconditioning and guarded movement. We also review the available assessment methods for the quantification of pain-related fear and avoidance. Finally, we discuss the implications of the recent findings for the prevention and treatment of chronic musculoskeletal pain. Although there are still a number of unresolved issues which merit future research attention, pain-related fear and avoidance appear to be an essential feature of the development of a chronic problem for a substantial number of patients with musculoskeletal pain.
3,695 citations
Journal Article•
TL;DR: A review of the existing evidence for the mediating role of pain‐related fear, and its immediate and long‐term consequences in the initiation and maintenance of chronic pain disability, and the implications of the recent findings for the prevention and treatment of chronic musculoskeletal pain.
Abstract: &NA; In an attempt to explain how and why some individuals with musculoskeletal pain develop a chronic pain syndrome, Lethem et al.(Lethem J, Slade PD, Troup JDG, Bentley G. Outline of fear‐avoidance model of exaggerated pain perceptions. Behav Res Ther 1983; 21: 401‐408).ntroduced a so‐called ‘fear‐avoidance’ model. The central concept of their model is fear of pain. ‘Confrontation’ and ‘avoidance’ are postulated as the two extreme responses to this fear, of which the former leads to the reduction of fear over time. The latter, however, leads to the maintenance or exacerbation of fear, possibly generating a phobic state. In the last decade, an increasing number of investigations have corroborated and refined the fear‐avoidance model. The aim of this paper is to review the existing evidence for the mediating role of pain‐related fear, and its immediate and long‐term consequences in the initiation and maintenance of chronic pain disability. We first highlight possible precursors of pain‐related fear including the role negative appraisal of internal and external stimuli, negative affectivity and anxiety sensitivity may play. Subsequently, a number of fear‐related processes will be discussed including escape and avoidance behaviors resulting in poor behavioral performance, hypervigilance to internal and external illness information, muscular reactivity, and physical disuse in terms of deconditioning and guarded movement. We also review the available assessment methods for the quantification of pain‐related fear and avoidance. Finally, we discuss the implications of the recent findings for the prevention and treatment of chronic musculoskeletal pain. Although there are still a number of unresolved issues which merit future research attention, pain‐related fear and avoidance appear to be an essential feature of the development of a chronic problem for a substantial number of patients with musculoskeletal pain.
3,661 citations
Cites background from "The Pain Catastrophizing Scale: Dev..."
...Pain catastrophizing is considered an exaggerated negative orientation toward noxious stimuli, and has been shown to mediate distress reactions to painful stimulation (Sullivan et al., 1995)....
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TL;DR: It is suggested that catastrophizing might best be viewed from the perspective of hierarchical levels of analysis, where social factors and social goals may play a role in the development and maintenance of catastrophize, whereas appraisal-related processes may point to the mechanisms that link catastrophization to pain experience.
Abstract: The tendency to "catastrophize" during painful stimulation contributes to more intense pain experience and increased emotional distress. Catastrophizing has been broadly conceived as an exaggerated negative "mental set" brought to bear during painful experiences. Although findings have been consistent in showing a relation between catastrophizing and pain, research in this area has proceeded in the relative absence of a guiding theoretical framework. This article reviews the literature on the relation between catastrophizing and pain and examines the relative strengths and limitations of different theoretical models that could be advanced to account for the pattern of available findings. The article evaluates the explanatory power of a schema activation model, an appraisal model, an attention model, and a communal coping model of pain perception. It is suggested that catastrophizing might best be viewed from the perspective of hierarchical levels of analysis, where social factors and social goals may play a role in the development and maintenance of catastrophizing, whereas appraisal-related processes may point to the mechanisms that link catastrophizing to pain experience. Directions for future research are suggested.
2,222 citations
Cites background or methods or result from "The Pain Catastrophizing Scale: Dev..."
...It has been shown that catastrophizing is associated with high levels of situational anxiety, anger, and sadness.(3) These transient subclinical states of emotional distress could be the vehicle through which catastrophizing impacts on pain experience....
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...Confounded measurement and construct redundancy In experimental and clinical samples, catastrophizing has been shown to be significantly correlated with depression, state and trait anxiety, fear of pain, and copingeffectiveness.(3,14,19) At times, the magnitude of correlations among these measures has been sufficiently high to question their operational and conceptual distinctiveness....
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...Prospective studies showing that catastrophizing, measured in a pain-free state, predicts future pain responses suggest that catastrophizing does not require the experience of pain for schema activation.(3,23) However, it must be recognized that pain may not be the only negative life event that can activate a pain schema and that schema activation may not be an all-or-none phenomenon....
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...It has also been suggested that catastrophizers may possess “pain schema” containing excessively negative information about pain-related experiences, and pessimistic beliefs about pain or the ability to cope with pain.(3,10) As a function of a learning history characterized by heightened pain experience, catastrophizers may develop expectancies about the high threat value of painful stimuli and about their inability to effectively manage the stress associated with painful experiences....
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...distress.(2,3,11) Catastrophizing has been broadly con-...
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TL;DR: The current state of scientific evidence for the individual components of the fear-avoidance model: pain severity, pain catastrophizing, attention to pain, escape/avoidance behavior, disability, disuse, and vulnerabilities is reviewed.
Abstract: Research studies focusing on the fear-avoidance model have expanded considerably since the review by Vlaeyen and Linton (Vlaeyen J. W. S. & Linton, S. J. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain, 85(3), 317--332). The fear-avoidance model is a cognitive-behavioral account that explains why a minority of acute low back pain sufferers develop a chronic pain problem. This paper reviews the current state of scientific evidence for the individual components of the model: pain severity, pain catastrophizing, attention to pain, escape/avoidance behavior, disability, disuse, and vulnerabilities. Furthermore, support for the contribution of pain-related fear in the inception of low back pain, the development of chronic low back pain from an acute episode, and the maintenance of enduring pain, will be highlighted. Finally, available evidence on recent clinical applications is provided, and unresolved issues that need further exploration are discussed.
1,900 citations
Cites background from "The Pain Catastrophizing Scale: Dev..."
...…related to higher pain intensity in a variety of situations, e.g. during a subsequent painful procedure (Edwards et al., 2004; Pavlin et al., 2005; Sullivan et al., 1995; Sullivan and Neish, 1999; Sullivan et al., 2004; Vlaeyen et al., 2004b), after an operation (Granot and Ferber, 2005), and in…...
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TL;DR: In this paper, the Cognitive Emotion Regulation Questionnaire (CEMQ) has been constructed, measuring nine cognitive coping strategies people tend to use after having experienced negative life events, and a test-retest design was used to study the psychometric properties and relationships with measures of depression and anxiety among 547 high school youngsters.
1,713 citations
References
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Book•
01 Jan 1974
TL;DR: In this paper, the authors present a detailed theory of psychological stress, building on the concepts of cognitive appraisal and coping, which have become major themes of theory and investigation in psychology.
Abstract: Here is a monumental work that continues in the tradition pioneered by co-author Richard Lazarus in his classic book Psychological Stress and the Coping Process. Dr. Lazarus and his collaborator, Dr. Susan Folkman, present here a detailed theory of psychological stress, building on the concepts of cognitive appraisal and coping which have become major themes of theory and investigation. As an integrative theoretical analysis, this volume pulls together two decades of research and thought on issues in behavioral medicine, emotion, stress management, treatment, and life span development. A selective review of the most pertinent literature is included in each chapter. The total reference listing for the book extends to 60 pages. This work is necessarily multidisciplinary, reflecting the many dimensions of stress-related problems and their situation within a complex social context. While the emphasis is on psychological aspects of stress, the book is oriented towards professionals in various disciplines, as well as advanced students and educated laypersons. The intended audience ranges from psychiatrists, clinical psychologists, nurses, and social workers to sociologists, anthropologists, medical researchers, and physiologists.
37,447 citations
"The Pain Catastrophizing Scale: Dev..." refers background in this paper
...…model linking the different dimensions of catastrophizing, at a descriptive level, magnification, rumination , and helplessness share features with primary and secondary appraisal processes that have been discussed in relation to coping with stress (Jensen et al., 1991; Lazarus and Folkman, 1984)....
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...Although the present study was not intended as a test of a particular theoretical model linking the different dimensions of catastrophizing, at a descriptive level, magnification, rumination, and helplessness share features with primary and secondary appraisal processes that have been discussed in relation to coping with stress (Jensen et al., 1991; Lazarus and Folkman, 1984)....
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TL;DR: In this paper, a general formula (α) of which a special case is the Kuder-Richardson coefficient of equivalence is shown to be the mean of all split-half coefficients resulting from different splittings of a test, therefore an estimate of the correlation between two random samples of items from a universe of items like those in the test.
Abstract: A general formula (α) of which a special case is the Kuder-Richardson coefficient of equivalence is shown to be the mean of all split-half coefficients resulting from different splittings of a test. α is therefore an estimate of the correlation between two random samples of items from a universe of items like those in the test. α is found to be an appropriate index of equivalence and, except for very short tests, of the first-factor concentration in the test. Tests divisible into distinct subtests should be so divided before using the formula. The index
$$\bar r_{ij} $$
, derived from α, is shown to be an index of inter-item homogeneity. Comparison is made to the Guttman and Loevinger approaches. Parallel split coefficients are shown to be unnecessary for tests of common types. In designing tests, maximum interpretability of scores is obtained by increasing the first-factor concentration in any separately-scored subtest and avoiding substantial group-factor clusters within a subtest. Scalability is not a requisite.
37,235 citations
"The Pain Catastrophizing Scale: Dev..." refers methods in this paper
...Coefficient alpha for the total PCS was .87 (Cronbach, 1951 )....
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TL;DR: The difficulties inherent in obtaining consistent and adequate diagnoses for the purposes of research and therapy have been pointed out and a wide variety of psychiatric rating scales have been developed.
Abstract: The difficulties inherent in obtaining consistent and adequate diagnoses for the purposes of research and therapy have been pointed out by a number of authors. Pasamanick12in a recent article viewed the low interclinician agreement on diagnosis as an indictment of the present state of psychiatry and called for "the development of objective, measurable and verifiable criteria of classification based not on personal or parochial considerations, but on behavioral and other objectively measurable manifestations." Attempts by other investigators to subject clinical observations and judgments to objective measurement have resulted in a wide variety of psychiatric rating scales.4,15These have been well summarized in a review article by Lorr11on "Rating Scales and Check Lists for the Evaluation of Psychopathology." In the area of psychological testing, a variety of paper-and-pencil tests have been devised for the purpose of measuring specific
35,176 citations
"The Pain Catastrophizing Scale: Dev..." refers methods in this paper
...Depression was measured with the Beck Depression Inventory (BDI; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961 ), and trait anxiety was measured using the State-Trait Anxiety Inventory-Trait Form (STAI; Speilberger, Gorsuch, & Lushene, 1970)....
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TL;DR: Two 10-item mood scales that comprise the Positive and Negative Affect Schedule (PANAS) are developed and are shown to be highly internally consistent, largely uncorrelated, and stable at appropriate levels over a 2-month time period.
Abstract: In recent studies of the structure of affect, positive and negative affect have consistently emerged as two dominant and relatively independent dimensions. A number of mood scales have been created to measure these factors; however, many existing measures are inadequate, showing low reliability or poor convergent or discriminant validity. To fill the need for reliable and valid Positive Affect and Negative Affect scales that are also brief and easy to administer, we developed two 10-item mood scales that comprise the Positive and Negative Affect Schedule (PANAS). The scales are shown to be highly internally consistent, largely uncorrelated, and stable at appropriate levels over a 2-month time period. Normative data and factorial and external evidence of convergent and discriminant validity for the scales are also presented.
34,482 citations
01 Jan 1970
TL;DR: The STAI as mentioned in this paper is an indicator of two types of anxiety, the state and trait anxiety, and measure the severity of the overall anxiety level, which is appropriate for those who have at least a sixth grade reading level.
Abstract: The STAI serves as an indicator of two types of anxiety, the state and trait anxiety, and measure the severity of the overall anxiety level.The STAI, which is appropriate for those who have at least a sixth grade reading level, contains four-point Likert items. The instrument is divided into two sections, each having twenty questions. Approximately 15 minutes are required for adults to complete the both STAI. The number on the scale is positively correlated to the anxiety related to in the question.
24,997 citations
"The Pain Catastrophizing Scale: Dev..." refers methods in this paper
...Depression was measured with the Beck Depression Inventory (BDI; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961),and trait anxiety was measured using the State–Trait Anxiety Inventory–Trait Form (STAI; Speilberger, Gorsuch, & Lushene, 1970)....
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