The relationship between cognitive appraisal, affect, and catastrophizing in patients with chronic pain

A study was conducted to clarify the nature of catastrophizing, a construct that is frequently referred to in the chronic pain literature. Information regarding 3 affective experience and 3 affect regulation dimensions was gathered from a heterogeneous sample of 104 chronic pain patients by using a semistructured clinical interview and the Affect Regulation and Experience Q-Sort (AREQ). Self-report questionnaires included visual analog pain scales, the Coping Strategies Questionnaire (CSQ), Multidimensional Pain Inventory (MPI), McGill Pain Questionnaire (MPQ), and Center for Epidemiological Studies Depression scale (CES-D). Hierarchical multiple regression was used to demonstrate the relative contributions of affective and cognitive appraisal components of catastrophizing. Thirty-one percent of the variance in CSQ-Catastrophizing scores was explained by a combination of cognitive appraisal variables (perceived ability to control pain; MPI Life Control) and AREQ scores, even after adjusting for pain severity and chronicity, age, and sex of participants. Results of the study strongly suggest that, rather than thinking of catastrophizing primarily as a cognitive coping construct, it should be described as an elaborate construct made up of both cognitive appraisal and affective components. Implications for tailoring interventions to match individual styles of affect regulation are discussed.