The reciprocal associations between catastrophizing and pain outcomes in patients being treated for neuropathic pain: A cross-lagged panel analysis study

Mélanie Racine, Dwight E. Moulin, Warren R. Nielson, Patricia K. Morley-Forster, Mary Lynch, Alexander J. Clark, Larry Stitt, Allan Gordon, Howard Nathan, Catherine Smyth, Mark A. Ware, Mark P. Jensen

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45 Citas (Scopus)

Resumen

Catastrophizing is recognized as a key psychosocial factor associated with pain-related negative outcomes in individuals with chronic pain. Longitudinal studies are needed to better understand the temporal relationship between these constructs. The aim of this study was to determine if changes in catastrophizing early in treatment predicted subsequent changes in pain intensity and interference later in treatment, or alternately, if early changes in pain intensity and interference predicted subsequent changes in catastrophizing. A total of 538 patients with neuropathic pain were recruited from 6 multidisciplinary pain clinics across Canada. Study participants were asked to complete measures of catastrophizing, pain intensity, and interference when first seen in the clinic and then again at 3- and 6-month follow-ups. Cross-lagged panel analyses were used to determine the temporal associations among the study variables. The results showed that decreases in catastrophizing early in treatment prospectively predicted improvement in both pain intensity and interference later in treatment. Converse temporal relationships were also found, where a reduction in pain intensity and interference early in treatment predicted a subsequent diminishing of catastrophizing. All 4 unique cross-lagged correlations significantly accounted for an additional 4% to 7% of the total variance. The findings are consistent with theoretical models hypothesizing a causal impact of catastrophizing on pain, suggesting a mutual causation between these factors. The results support that treatments targeting catastrophizing may influence other pain-related outcomes, and conversely that treatments aiming to reduce pain could potentially influence catastrophizing. There may therefore be multiple paths to positive outcomes.

Idioma originalEnglish
Páginas (desde-hasta)1946-1953
Número de páginas8
PublicaciónPain
Volumen157
N.º9
DOI
EstadoPublished - sep. 1 2016

Nota bibliográfica

Funding Information:
The authors have no conflicts of interest to declare. This study was funded by the Canadian Foundation for Innovation (Grant no. 7878) and by Pfizer Canada. M. Racine was funded by The Earl Russell Chair in Pain Medicine, Western University, London, Ontario, and by a bequest from the estate of Mrs. Beryl Ivey to W. R. Nielson. Thanks are due to Charlene Bartha for coordinating data collection, and to Martin-Luc Girard for his helpful assistance in reviewing and editing the manuscript.

Publisher Copyright:
© 2016 International Association for the Study of Pain.

ASJC Scopus Subject Areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

PubMed: MeSH publication types

  • Journal Article
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

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