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Catastrophizing, Depression and Anxiety During Pregnancy: Relation Between Lumbopelvic Pain and Physical/Social Functioning

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Abstract

Catastrophizing, a cognitive behavioral aspect of pain, is defined as an excessively negative orientation against a noxious stimulus. The primary goal of the present study is to assess the association between catastrophizing and lumbopelvic pain intensity during the pregnancy period, the secondary goal is to explore the variation of pain catastrophizing, anxiety and depression, and the tertiary goal is to investigate the relationship between catastrophizing and quality of life. After approval, pregnant women with lumbopelvic pain were invited to join in the study. During admission, participants were asked to complete questionnaires including Pain Catastrophizing Scale, Beck Anxiety Inventory, Beck Depression Inventory-II, and Short Form-36. Age, gravida, parity, number of abortus, number of live-births and the pain intensity score were recorded. A total of 429 women were enrolled in the study. Pain catastrophizing scores showed a fluctuation during pregnancy, and were significantly correlated with the scores of Beck Anxiety Inventory, Beck Depression Inventory, Visual Analog Scale, and Short Form-36 sub-scales including social functioning, vitality, physical functioning and mental health. The present study demonstrated that catastrophizing level shows an alteration throughout the pregnancy period, and variation in catastrophizing shows an approximately similar course with pain intensity, depression and anxiety.

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References

  • Arnow, B. A., Blasey, C. M., Constantino, M. J., Robinson, R., Hunkeler, E., Lee, J., et al. (2011). Catastrophizing, depression and pain related disability. General Hospital Psychiatry, 33(2), 150–156.

    Article  PubMed  Google Scholar 

  • Atlantis, E., Chow, C. M., Kirby, A., & Singh, M. F. (2004). An effective exercise-based intervention for improving mental health and quality of life measures: A randomized controlled trial. Preventive Medicine, 39(2), 424–434.

    Article  PubMed  Google Scholar 

  • Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893–897.

    Article  PubMed  Google Scholar 

  • Beck, A. T., Steer, R. A., Ball, R., & Ranieri, W. (1996). Comparison of Beck depression inventories-IA and -II in psychiatric outpatients. Journal of Personality Assessment, 67(3), 588–597.

    Article  PubMed  Google Scholar 

  • Benza, S., & Liamputtong, P. (2014). Pregnancy, childbirth and motherhood: A meta-synthesis of the lived experiences of immigrant women. Midwifery, 30(6), 575–584.

    Article  PubMed  Google Scholar 

  • Bishop, A., Ogollah, R., Bartlam, B., Barlas, P., Holden, M. A., Ismail, K. M., et al. (2016). Evaluating acupuncture and standard care for pregnant women with back pain: The EASE Back pilot randomised controlled trial (ISRCTN49955124). Pilot and Feasibility Studies, 2, 72.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bize, R., Johnson, J. A., & Plotnikoff, R. C. (2007). Physical activity level and health-related quality of life in the general adult population: A systematic review. Preventive Medicine, 45(6), 401–415.

    Article  PubMed  Google Scholar 

  • Bower, S., Campbell, S., Vyas, S., & McGirr, C. (1991). Braxton–Hicks contractions can alter uteroplacental perfusion. Ultrasound in Obstetrics and Gynecology, 1(1), 46–49.

    Article  PubMed  Google Scholar 

  • Campbell, C. M., Kronfli, T., Buenaver, L. F., Smith, M. T., Berna, C., Haythornthwaite, J. A., et al. (2010). Situational versus dispositional measurement of catastrophizing: Associations with pain responses in multiple samples. Journal of Pain, 11(5), 443–453.

    Article  PubMed  PubMed Central  Google Scholar 

  • Carr, E. C., Nicky Thomas, V., & Wilson-Barnet, J. (2005). Patient experiences of anxiety, depression and acute pain after surgery: A longitudinal perspective. International Journal of Nursing Studies, 42(5), 521–530.

    Article  PubMed  Google Scholar 

  • Carriere, J. S., Thibault, P., Milioto, M., & Sullivan, M. J. (2015). Expectancies mediate the relations among pain catastrophizing, fear of movement, and return to work outcomes after whiplash injury. Journal of Pain, 16(2), 1280–1287.

    Article  PubMed  Google Scholar 

  • Chaves, J. F., & Brown, J. M. (1987). Spontaneous cognitive strategies for the control of clinical pain and stress. Journal of Behavioral Medicine, 10(3), 263–276.

    Article  PubMed  Google Scholar 

  • Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 119–155.

    Article  Google Scholar 

  • den Hollander, M., de Jong, J. R., Volders, S., Goossens, M. E., Smeets, R. J., & Vlaeyen, J. W. (2010). Fear reduction in patients with chronic pain: A learning theory perspective. Expert Review of Neurotherapeutics, 10(11), 1733–1745.

    Article  Google Scholar 

  • Edwards, R. R., Cahalan, C., Mensing, G., Smith, M., & Haythornwaite, J. A. (2011). Pain, catastrophizing, and depression in rheumatic diseases. Nature Reviews Rheumatology, 7(4), 216–224.

    Article  PubMed  Google Scholar 

  • Ellis, A. (1962). Reason and emotion in psychotherapy. Secaucus, NJ: Lyle Stuart.

    Google Scholar 

  • Emmons, C. A., Fetting, J. H., & Zonderman, A. B. (1987). A comparison of the symptoms of medical and psychiatric patients matched on the Beck depression inventory. General Hospital Psychiatry, 9(6), 398–404.

    Article  PubMed  Google Scholar 

  • Fairbrother, N., Young, A. H., Janssen, P., Antony, M. M., & Tucker, E. (2015). Depression and anxiety during the perinatal period. BMC Psychiatry, 15, 206.

    Article  PubMed  PubMed Central  Google Scholar 

  • Glinkowski, W. M., Tomasik, P., Walesiak, K., Głuszak, M., Krawczak, K., Michoński, J., et al. (2016). Posture and low back pain during pregnancy—3D study. Ginekologia Polska, 87(8), 575–580.

    Article  PubMed  Google Scholar 

  • Gorman, L. L., O’Hara, M. W., Figueiredo, B., Hayes, S., Jacquemain, F., Kammerer, M. H., et al. (2004). Adaptation of the structured clinical interview for DSM-IV disorders for assessing depression in women during pregnancy and post-partum across countries and cultures. The British Journal of Psychiatry, 46, s17–s23.

    Article  PubMed  Google Scholar 

  • Gutke, A., Lundberg, M., Östgaard, H. C., & Öberg, B. (2011). Impact of postpartum lumbopelvic pain on disability, pain intensity, health-related quality of life, activity level, kinesiophobia, and depressive symptoms. European Spine Journal, 20(3), 440–448.

    Article  PubMed  Google Scholar 

  • Haas, J. S., Jackson, R. A., Fuentes-Afflick, E., Stewart, A. L., Dean, M. L., Brawarsky, P., et al. (2005). Changes in the health status of women during and after pregnancy. Journal of General Internal Medicine, 20(1), 45–51.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hansen, A., Jensen, D. V., Larsen, E. C., Wilken-Jensen, C., Kaae, B. E., Frølich, S., et al. (2005). Postpartum pelvic pain–the “pelvic joint syndrome”: A follow-up study with special reference to diagnostic methods. Acta Obstetricia et Gynecologica Scandinavica, 84(2), 170–176.

    Article  PubMed  Google Scholar 

  • Harts, C. C., Helmhout, P. H., de Bie, R. A., & Staal, J. B. (2008). A high-intensity lumbar extensor strengthening program is little better than a low-intensity program or a waiting list control group for chronic low back pain: A randomised clinical trial. Australian Journal of Physiotherapy, 54(1), 23–31.

    Article  PubMed  Google Scholar 

  • Hawker, G. A., Mian, S., Kendzerska, T., & French, M. (2011). Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care & Research, 63(11), 240–252.

    Article  Google Scholar 

  • Herbert, M. S., Goodin, B. R., Pero, S. T., Scmidt, J. K., Sotolongo, A., Bulls, H. W., et al. (2014). Pain hypervigilance is associated with greater clinical pain severity and enhanced experimental pain sensitivity among adults with symptomatic knee osteoarthritis. Annals of Behavioral Medicine, 48(1), 50–60.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hisli, N. (1989). Beck depresyon envanterinin üniversite öğrencileri için geçerliği, güvenirliği. Psikoloji Dergisi, 7(23), 8–13.

    Google Scholar 

  • Ip, H. Y., Abrishami, A., Peng, P. W., Wong, J., & Chung, F. (2009). Predictors of postoperative pain and analgesic consumption: A qualitative systematic review. Anesthesiology, 111(3), 657–777.

    Article  PubMed  Google Scholar 

  • Kapçı, E. G., Uslu, R., Türkçapar, H., & Karaoğlan, A. (2008). Beck depression inventory. Its psychometric evaluation in turkish adults. Depression and Anxiety, 25(10), 104–110.

    Article  Google Scholar 

  • Katonis, P., Kampouroglou, A., Aggelopoulos, A., Kakavelakis, K., Lykoudis, S., Makrigiannakis, A., et al. (2011). Pregnancy-related low back pain. Hippokratia, 15(3), 205–210.

    PubMed  PubMed Central  Google Scholar 

  • Katz, J., Poleshuck, E. L., Andrus, C. H., Hogan, L. A., Jung, B. F., Kulick, D. I., et al. (2005). Risk factors for acute pain and its persistence following breast cancer surgery. Pain, 119(1–3), 16–25.

    Article  PubMed  Google Scholar 

  • Leung, L. (2012). Pain catastrophizing: An updated review. Indian Journal of Psychological Medicine, 34(3), 204–217.

    Article  PubMed  PubMed Central  Google Scholar 

  • Madhavanprabhakaran, G. K., D’Souza, M. S., & Subrahmanya, K. (2015). Prevalence of pregnancy anxiety and associated factors. International Journal of Africa Nursing Sciences, 3, 1–7.

    Article  Google Scholar 

  • Moseley, G. L. (2004). Evidence for a direct relationship between cognitive and physical change during an education intervention in people with chronic low back pain. European Journal of Pain, 8(1), 39–45.

    Article  PubMed  Google Scholar 

  • Ogunlana, M. O., Odole, A. C., Adejumo, A., & Odunaiya, N. (2015). Catastrophizing, pain, and disability in patients with nonspesific low back pain. Hong Kong Physiotherapy Journal, 33(2), 73–79.

    Article  Google Scholar 

  • Olsson, C., Buer, N., Holm, K., & Nilsson-Wikmar, L. (2009). Lumbopelvic pain associated with catastrophizing and fear-avoidance beliefs in early pregnancy. Acta Obstetricia et Gynecologica Scandinavica, 88(4), 378–385.

    Article  PubMed  Google Scholar 

  • Olsson, C. B., Grooten, W. J., Nilsson-Wikmar, L., Harms-Ringdahl, K., & Lundberg, M. (2012a). Catastrophizing during and after pregnancy: Associations with lumbopelvic pain and postpartum physical ability. Physical Therapy, 92(1), 49–57.

    Article  PubMed  Google Scholar 

  • Olsson, C. B., Nilsson-Wikmar, L., & Grooten, W. J. (2012b). Determinants for lumbopelvic pain 6 months postpartum. Disability and Rehabilitation, 34(5), 416–422.

    Article  PubMed  Google Scholar 

  • Ozalp, G., Sarioglu, R., Tuncel, G., Aslan, K., & Kadiogullari, N. (2003). Preoperative emotional states in patients with breast cancer and postoperative pain. Acta Anaesthesiologica Scandinavica, 47(1), 26–29.

    Article  PubMed  Google Scholar 

  • Robleda, G., Sillero-Sillero, A., Puig, T., Gich, I., & Baños, J.-E. (2014). Influence of preoperative emotional state on postoperative pain following orthopedic and trauma surgery. Revista Latino-Americana de Enfermagem, 22(5), 785–791.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ronchetti, I., Vleeming, A., & van Wingerden, J. P. (2008). Physical characteristics of women with severe pelvic girdle pain after pregnancy: A descriptive cohort study. Spine, 33(5), E145–E151.

    Article  PubMed  Google Scholar 

  • Smeets, R. J., Vlaeyen, J. W., Kester, A. D., & Knottnerus, J. A. (2006). Reduction of pain catastrophizing mediates the outcome of both physical and cognitive-behavioral treatment in chronic low back pain. The Journal of Pain, 7(4), 261–271.

    Article  PubMed  Google Scholar 

  • Spanos, N. P., Radtke-Bodorik, H. L., Ferguson, J. D., & Jones, B. (1979). The effects of hypnotic susceptibility, suggestions for analgesia, and the utilization of cognitive strategies on the reduction of pain. Journal of Abnormal Psychology, 88(3), 282–292.

    Article  PubMed  Google Scholar 

  • Spinhoven, P., Ter Kuile, M., Kole-Snijders, A. M., Hutten Mansfeld, M., Den Ouden, D. J., & Vlaeyen, J. W. (2004). Catastrophizing and internal pain control as mediators of outcome in the multidisciplinary treatment of chronic low back pain. European Journal of Pain, 8(3), 211–219.

    Article  PubMed  Google Scholar 

  • Sullivan, M. J., Adams, H., Rhodenizer, T., & Stanish, W. D. (2006). A psychosocial risk factor-targeted intervention for the prevention of chronic pain and disability following whiplash injury. Physical Therapy, 86(1), 8–18.

    Article  PubMed  Google Scholar 

  • Sullivan, M. J. L., Bishop, S. R., & Pivik, J. (1995). The Pain Catastrophizing Scale: Development and validation. Psychological Assessment, 7(4), 524–532.

    Article  Google Scholar 

  • Sullivan, M. J., Stanish, W., Sullivan, M. E., & Tripp, D. (2002). Differential predictors of pain and disability in patients with whiplash injuries. Pain Research & Management, 7(2), 68–74.

    Article  Google Scholar 

  • Suren, M., Kaya, Z., Gokbakan, M., Okan, I., Arici, S., Karaman, S., et al. (2014). The role of pain catastrophizing score in the prediction of venipuncture pain severity. Pain Practice, 14(3), 245–251.

    Article  PubMed  Google Scholar 

  • Taylor, A. M., Harris, A. D., Varnava, A., Phillips, R., Taylor, J. O., Hughes, O., et al. (2015). A Functional Magnetic Resonance Imaging Study to investigate the utility of a picture imagination task in investigating neural responses in patients with chronic musculoskeletal pain to daily physical activity photographs. PLoS ONE, 10(10), e0141133.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tendais, I., Figueiredo, B., Mota, J., & Conde, A. (2011). Physical activity, health-related quality of life and depression during pregnancy. Cadernos de Saúde Pública, 27(2), 219–228.

    Article  PubMed  Google Scholar 

  • Thibault, P., Loisel, P., Durand, M. J., Catchlove, R., & Sullivan, M. J. (2008). Psychological predictors of pain expression and activity intolerance in chronic pain patients. Pain, 139(1), 47–54.

    Article  PubMed  Google Scholar 

  • Thorn, B. E., Pence, L. B., Ward, L. C., Kilgo, G., Clements, K. L., Cross, T. H., et al. (2007). A randomized clinical trial of targeted cognitive behavioral treatment to reduce catastrophizing in chronic headache sufferers. The Journal of Pain, 8(12), 938–949.

    Article  PubMed  Google Scholar 

  • Tiemann, L., Heitmann, H., Shultz, E., Baumkötter, J., & Ploner, M. (2014). Dopamine precursor depletion influences pain affect rather than pain sensation. PLoS ONE, 9(4), e96167.

    Article  PubMed  PubMed Central  Google Scholar 

  • Turk, D. C., & Wilson, H. D. (2010). Fear of pain as a prognostic factor in chronic pain: Conceptual models, assessment, and treatment implications. Current Pain and Headache Reports, 14(2), 88–95.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ulusoy, M., Sahin, N. H., & Erkmen, H. (1998). Turkish version of the Beck anxiety inventory: Psychometric properties. Journal of Cognitive Psychotherapy, 12(2), 163–172.

    Google Scholar 

  • Vaughn, F., Wichowski, H., & Bosworth, G. (2007). Does preoperative anxiety level predict postoperative pain? AORN Journal, 85(3), 589–604.

    Article  PubMed  Google Scholar 

  • Vincent, H. K., George, S. Z., Seay, A. N., Vincent, K. R., & Hurley, R. W. (2014). Resistance exercise, disability, and pain catastrophizing in obese adults with back pain. Medicine and Science in Sports and Exercise, 46(9), 1693–1701.

    Article  PubMed  PubMed Central  Google Scholar 

  • Vinturache, A., Stephenson, N., McDonald, S., Wu, M., Bayrampour, H., & Tough, S. (2015). Health-related quality of life in pregnancy and postpartum among women with assisted conception in Canada. Fertility and Sterility, 104(1), 188–195.

    Article  PubMed  Google Scholar 

  • Ware, J., Kosinski, M., Bjorner, J. B., Turner-Bowker, D. M., Gandek, B., & Maruish, M. E. (2007). Determining important differences in scores. User’s Manual for the SF-36v2 Health Survey. Lincoln, RI: Quality Metric Inc.

    Google Scholar 

  • Woby, S. R., Watson, P. J., Roach, N. K., & Urmston, M. (2004a). Are changes in fear-avoidance beliefs, catastrophizing, and appraisals of control, predictive of changes in chronic low back pain and disability? European Journal of Pain, 8(3), 201–210.

    Article  PubMed  Google Scholar 

  • Woby, S. R., Watson, P. J., Roach, N. K., & Urmston, M. (2004b). Adjustment to chronic low back pain—The relative influence of fear-avoidance beliefs, catastrophizing, and appraisals of control. Behaviour Research and Therapy, 42(7), 761–774.

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors wish to acknowledge the assistance of Selim Gulucu and Ismail Sag for their help in obtaining data.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Medical Faculty, Gaziosmanpaşa University, Ali Şevki Erek Yerleşkesi, 60200, Tokat, Turkey

    Hatice Yılmaz Doğru, Asker Zeki Özsoy & Bülent Çakmak

  2. Department of Psychiatry, Tokat State Hospital, Tokat, Turkey

    Filiz Özsoy

  3. Department of Anesthesiology and Reanimation, Medical Faculty, Gaziosmanpaşa University, Tokat, Turkey

    Serkan Doğru, Tuğba Karaman, Aynur Şahin & Mustafa Süren

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  1. Hatice Yılmaz Doğru
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  2. Filiz Özsoy
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Doğru, H.Y., Özsoy, F., Doğru, S. et al. Catastrophizing, Depression and Anxiety During Pregnancy: Relation Between Lumbopelvic Pain and Physical/Social Functioning. J Rat-Emo Cognitive-Behav Ther 36, 119–136 (2018). https://doi.org/10.1007/s10942-017-0277-z

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