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When Pain Catastrophizing Is Not Catastrophizing: Identifying Normative From Exaggerated Responses Relative to

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Summary

Pain catastrophizing scores vary with pain intensity, indicating they are not context-free. Understanding referent pain anchors is crucial for accurate interpretation of pain catastrophizing (PCS) scores.

Keywords:
Pain Catastrophizing Scale (PCS)mixed linear modelsnegative affectnegative emotionalitypain intensitypain rating schemarepeated measuresstate catastrophizingtrait catastrophizing

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Area of Science:

  • Psychology
  • Pain Research
  • Clinical Assessment

Background:

  • Pain catastrophizing is widely studied, but a clear definition of exaggerated responses versus proportional ones is lacking.
  • Current assessments often lack referent pain anchors, leaving the influence of pain context on catastrophic thinking unclear.

Purpose of the Study:

  • To assess the consistency of pain catastrophizing across different referent pain scenarios.
  • To characterize high pain catastrophizing as exaggerated responses relative to specific pain intensities.

Main Methods:

  • 228 adults completed the Pain Catastrophizing Scale (PCS) under standard and specific referent pain scenarios.
  • Intraclass correlations assessed cross-situational consistency; mixed linear models examined the PCS-referent pain relationship.

Main Results:

  • PCS demonstrated high cross-situational consistency (ICCs = 0.79-0.84).
  • However, PCS scores significantly varied with referent pain intensity (R=0.74, p<0.0001), with pain explaining 40% of score variability.
  • High catastrophizing thresholds were context-dependent on pain intensity, with no significant sex differences.

Conclusions:

  • Pain Catastrophizing Scale (PCS) scores are not context-free and should not be interpreted as such.
  • Variations in published PCS cut points may be influenced by differing referent pain contexts, necessitating score contextualization for accurate interpretation.