Catastrophizing, Pain, and Pain Interference in Individuals with Disabilities

Abstract

Objective: The aim of this study was to examine the influence of sex and disability on catastrophizing, pain intensity, and pain interference in individuals with a spinal cord injury or multiple sclerosis. Design: A cross-sectional survey design was used. Two hundred forty-eight community-dwelling adults with a physical disability (spinal cord injury, n = 124; multiple sclerosis, n = 124) and chronic pain completed measures of demographic and clinical characteristics, pain intensity and interference, psychologic functioning, and pain catastrophizing. Results: Men reported marginally greater catastrophizing (P < 0.10) than did the women across both disability groups; however, there was no significant difference in catastrophizing between the disability groups. Catastrophizing was the only significant predictor of pain intensity in the multivariate regression analysis, with greater catastrophizing associated with greater pain. Pain intensity and catastrophizing were the only significant variables in the regression analyses predicting pain interference and psychologic functioning; as hypothesized, greater pain intensity and catastrophizing were associated with more pain interference and poorer psychologic functioning. There was also a trend (P < 0.10) for women, relative to men, to have a stronger association between catastrophizing and pain interference. Conclusions: These findings are consistent with a biopsychosocial conceptualization of pain and functioning in individuals with chronic pain secondary to a physical disability. In addition, these data suggest that assessment and treatment (when indicated) of catastrophizing should be a regular part of the clinical management of these patients.