Pain catastrophizing and distress intolerance: prediction of pain and emotional stress reactivity
- 42 Downloads
Exposure to stress is associated with poor outcomes in people with chronic pain. Dispositional variables, such as pain catastrophizing and distress intolerance, may impact reactivity to stressors. Importantly, these variables can be modified with treatment. The aim of this study was to investigate whether pain catastrophizing and distress intolerance were associated with tolerance of a pain stressor or a psychosocial stressor, and heightened negative affect following these stressors. A sample of 50 adults with chronic pain completed self-report measures and pain and psychosocial stress inductions. Results indicated that pain catastrophizing was associated with heightened anxiety during pain induction. Distress intolerance was associated with negative affect following a psychosocial stressor, and with poorer tolerance of the psychosocial stressor. Pain catastrophizing and distress intolerance are related factors, however, they exhibit distinct associations with amplification of pain and psychosocial stress reactivity. These variables may be important treatment targets in people with chronic pain.
KeywordsChronic pain Pain catastrophizing Distress intolerance Stress reactivity Opioids
This study was funded by the National Institute on Drug Abuse (Grant Numbers DA034102 and DA035297).
Compliance with ethical standards
Conflict of interest
Dr. Weiss has been a consultant to Indivior, Alkermes, Braeburn Pharmaceuticals, GW Pharmaceuticals, US World Meds, Janssen Pharmaceuticals and Daiichi Sankyo. Drs. McHugh, Kneeland, Edwards and Jamison report no potential conflicts of interest relevant to this manuscript.
Human and animal rights and informed consent
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
- Dugas, M. J., Buhr, K., & Ladouceur, R. (2004). The role of intolerance of uncertainty in etiology and maintenance. In R. G. Heimberg, C. L. Turk, & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 143–163). New York, NY, US: Guilford Press.Google Scholar
- Hübscher, M., Moloney, N., Leaver, A., Rebbeck, T., McAuley, J. H., & Refshauge, K. M. (2013). Relationship between quantitative sensory testing and pain or disability in people with spinal pain-a systematic review and meta-analysis. Pain, 154, 1497–1504. https://doi.org/10.1016/j.pain.2013.05.031 CrossRefGoogle Scholar
- Kahler, C. W., McHugh, R. K., Metrik, J., Spillane, N. S., & Rohsenow, D. J. (2012). Breath holding duration and self-reported smoking abstinence intolerance as predictors of smoking lapse behavior in a laboratory analog task. Nicotine & Tobacco Research, 15, 1151–1154. https://doi.org/10.1093/ntr/nts231 CrossRefGoogle Scholar
- Kjøgx, H., Kasch, H., Zachariae, R., Svensson, P., Jensen, T. S., & Vase, L. (2016). Experimental manipulations of pain catastrophizing influence pain levels in patients with chronic pain and healthy volunteers. Pain, 157, 1287–1296. https://doi.org/10.1097/j.pain.0000000000000519 CrossRefGoogle Scholar
- Marcuzzi, A., Dean, C. M., Wrigley, P. J., & Hush, J. M. (2015). Early changes in somatosensory function in spinal pain: A systematic review and meta-analysis. Pain, 156, 203–214. https://doi.org/10.1097/01.j.pain.0000460300.10583.f6 CrossRefGoogle Scholar
- Martel, M. O., Dolman, A. J., Edwards, R. R., Jamison, R. N., & Wasan, A. D. (2014). The association between negative affect and prescription opioid misuse in patients with chronic pain: The mediating role of opioid craving. The Journal of Pain, 15, 90–100. https://doi.org/10.1016/j.jpain.2013.09.014 CrossRefGoogle Scholar
- Peterson, R. A., & Reiss, S. (1992). Anxiety Sensitivity Index- revised manual. Worthington, OH: International Diagnostic Systems Publishing Corporation.Google Scholar
- Sirota, A. D., Rohsenow, D. J., MacKinnon, S. V., Martin, R. A., Eaton, C. A., Kaplan, G. B., et al. (2010). Intolerance for Smoking Abstinence Questionnaire: Psychometric properties and relationship to tobacco dependence and abstinence. Addictive Behaviors, 35, 686–693. https://doi.org/10.1016/j.addbeh.2010.02.014 CrossRefGoogle Scholar
- Strong, D. R., Lejeuz, C. W., Daughters, S., Marinello, M., Kahler, C. W., & Brown, R. A. (2003). The computerized mirror tracing task, version 1 (Unpublished manual).Google Scholar
- Turner, J. A., Anderson, M. L., Balderson, B. H., Cook, A. J., Sherman, K. J., & Cherkin, D. C. (2016). Mindfulness-based stress reduction and cognitive behavioral therapy for chronic low back pain: Similar effects on mindfulness, catastrophizing, self-efficacy, and acceptance in a randomized controlled trial. Pain, 157, 2434–2444.CrossRefGoogle Scholar
- Vachon-Presseau, E., Martel, M. O., Roy, M., Caron, E., Albouy, G., Marin, M. F., et al. (2013). Acute stress contributes to individual differences in pain and pain-related brain activity in healthy and chronic pain patients. Journal of Neuroscience, 33, 6826–6833. https://doi.org/10.1523/JNEUROSCI.4584-12.2013 CrossRefGoogle Scholar