Pain catastrophizing predicts pain intensity, disability, and psychological distress independent of the level of physical impairment

Objective: The aim of the current study was to examine the relation betweencatastrophizing and pain intensity, pain-related disability, and psychological distress ina group of patients with chronic pain, controlling for the level of physical impairment.Furthermore, it was examined whether these relations are the same for three subgroupsof chronic pain patients: those with chronic low back pain, those with chronic mus-culoskeletal pain other than low back pain, and those with miscellaneous chronic paincomplaints, low back pain and musculoskeletal pain excluded.

Design: Correlational, cross-sectional.

Patients and Setting: Participants in this study were 211 consecutive referralspresenting to a university hospital pain management and research center, all of whomhad a chronic pain problem.

Results: Overall, chronic pain patients who catastrophize reported more pain in-tensity, felt more disabled by their pain problem, and experienced more psychologicaldistress. Regression analyses revealed that catastrophizing was a potent predictor ofpain intensity, disability, and psychological distress, even when controlled for physicalimpairment. No fundamental differences between the three subgroups were found inthis respect. Finally, it was demonstrated that there was no relation between physicalimpairment and catastrophizing.

Conclusions: It was concluded that for different subgroups of chronic pain patients,catastrophizing plays a crucial role in the chronic pain experience, significantly con-tributing to the variance of pain intensity, pain-related disability, and psychologicaldistress. These relations are not confounded by the level of physical impairment. Someclinical implications of the results are discussed. Finally, the authors concluded thatthese results support the validity of a cognitive–behavioral conceptualization ofchronic pain–related disability.